Differences and Similarities Between Children and Adults With Rhupus Syndrome

In this study, we aimed to evaluate and compare the characteristics of pediatric and adult rhupus patients.

Thirty pediatric patients with rhupus syndrome and 15 adult patients with rhupus syndrome were included in this study. Similarities and differences between both groups were evaluated.

The time elapsed between the diagnosis of juvenile idiopathic arthritis (JIA)/rheumatoid arthritis (RA) and the diagnosis of systemic lupus erythematosus (SLE) was longer in adults than in pediatric patients (p < 0.001). While the most common phenotypes at disease onset were JIA/RA in both adults and children, SLE was more prevalent in pediatric patients and RA in adult patients at the last visit (both p < 0.001). Cutaneous findings, oral ulcers, hematological and renal involvement, hypocomplementemia, and antidouble-stranded DNA positivity were more frequent in pediatric patients, whereas constitutional findings, nonscarring alopecia, neuropsychiatric involvement, and anticyclic citrullinated peptide positivity were more common in adults (all p < 0.001). Asymmetric polyarthritis was more prevalent in pediatric patients, whereas symmetric polyarthritis was more common in adult patients (both p < 0.001). Erosive arthritis was more frequently observed in adult patients (p < 0.001). In the treatment, mycophenolate mofetil was more commonly prescribed to pediatric patients, while rituximab was more frequently used for adult patients in the treatment of SLE compared to pediatric patients (both p < 0.001). Additionally, leflunomide was more commonly used in JIA/RA treatment in adult patients compared to pediatric patients (p < 0.001).

This is the first study comparing pediatric and adult patients with rhupus syndrome. Revealing these differences and similarities will contribute significantly to the literature.