ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 389

Clinical and Serological Differences Between Juvenile-Onset and Adult-Onset Systemic LUPUS Erythematosus Patients from a National Registry of Patients

TC Salman-Monte1, V Torrente-Segarra2, I Rúa-Figueroa3, J Calvo-Alen4,5, FJ Lopez Longo6,7, M Galindo8,9 and JM Pego-Reigosa10, 1Rheumatology, Hospital del Mar/Parc de Salut Mar, Barcelona, Spain, 2Rheumatology, Hospital General Hospitalet-Moisès Broggi, Hospitalet Llobregat, Spain, 3Rheumatology, Hospital de GC Dr Negrin, Las Palmas GC, Spain, 4Rheumatology Division, Sierrallana Hospital, Torrelavega, Spain, 5Rheumatology, Hospital Sierrallana. Torrelavega, Torrelavega, Spain, 6Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 7Rheumatology, Gregorio Marañón Hospital, Madrid, Spain, 8Servicio de Reumatología, Instituto de Investigación Hospital 12 de Octubre (I+12), Madrid, Spain, 9Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, 10Rheumatology, EOXI Vigo, Vigo, Spain

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Sunday, November 8, 2015

Title: Pediatric Rheumatology – Clinical and Therapeutic Aspects Poster I: Lupus, Scleroderma, JDMS

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To assess clinical and serological differences between patients with juvenile-onset systemic lupus erythematosus (jSLE) and adult-onset (aSLE) from a National database.Methods: Data included in the transverse phase of the National Register of lupus of the Spanish Society of Rheumatology (RELESSER –T) were analysed, which includes retrospective data from SLE patients. Inclusion criteria: patients with SLE with > or = 4 ACR criteria for SLE who were divided into 2 groups: disease date onset < 18 years and > 18. Sociodemographic, clinical, serological, activity, treatment and cumulative damage and chronicity data were collected. Associative descriptive statistical analysis was performed.Results: we reviewed 3.428 aSLE (89.6 % women) and 484 jSLE (89.8 % girls), 93.1 % Caucasian in both groups; age at diagnosis: 38.1±14 and 16.6 ± 6.3 years, respectively; average delay in diagnosis 24.7±47.4 and 39.9±5 months, respectively; mean age at followup: 48.8 ± 14.3, 31.5 ± 30 years, respectively. Table 1 shows all significant differences (p <0.05). In aSLE 68.7 % had positive anti-DNA Ab vs. 82.9 % of jSLE (p < 0.001). Table 1

VARIABLE

aSLE

(N=3.428)

jSLE

(N=484)

p-value

Nephritis

No

Yes

2491 (74.1%)

867 (25.9%)

256 (54.2%)

216 (45.8%)

0.000

HTA (with nephritis)

No

Yes

2966 (90.0%)

328 (10%)

385 (84.6%)

70 (15.4%)

0.000

Creat clearance <5

No

Yes

3184 (95.2%)

160 (4.8%)

430 (97.2%)

36 (7.8%)

0.007

Proteinuria >3.5 g/24hs

No

Yes

3226 (96.8%)

106 (3.2%)

437 (94.5%)

26 (5.5%)

0.007

Chronic renal failure

No

Yes

3241 (97.8%)

72 (2.2%)

437 (94.1%)

27 (5.9%)

0.000

Recurrent nephritis

No

Yes

1641 (87.3%)

237 (12.7%)

227 (74.9%)

76 (25.1%)

0.000

AntiDNAds Ab

No

Yes

1048 (31.3%)

2300 (68.7%)

80 (17.0%)

391 (83.0%)

<0.001

Organic brain syndrome

No

Yes

3282 (97.5%)

83 (2.5%)

448 (94.7%)

25 (5.3%)

0.001

TTP

No

Yes

3286 (97.8%)

72 (2.2%)

452 (96.3%)

17 (3.7%)

0.046

SLE family background

No

Yes

2128 (84.8%)

381 (15.2%)

286 (78.7%)

77 (21.3%)

0.003

SLEDAI

 

2.4 ± 3.5

2 [0-4]

3.3 ± [4.1]

2 [0-4]

0.000

KATZ

 

2.4 ± 1.5

2 [1-3]

3.1 ± 1.9

3 [2-4]

0.000

CHARLSON

 

2.4 ± 1.9

2 [1-3]

1.6 ± 1.2

1 [1-2]

0.000

Steroid treatment (ever)

No

Yes

450 (13.7%)

2813 (86.3%)

33 (7.0%)

433 (93%)

0.000

Azathioprine

No

Yes

2295 (70.9%)

939 (29.1%)

33 (26.8%)

90 (73.2%)

0.000

Ciclophosphamide

No

Yes

2633 (81.3%)

604 (18.7%)

296 (63.9%)

167 (36.1%)

0.000

Micophenolate Mofetil

No

Yes

2824 (87.6%)

399 (12.4%)

345 (75.3%)

113 (24.7%)

0.034

Mycophenolic acid

No

Yes

3112 (97.9%)

66 (2.1%)

425 (95.4%)

18 (4.6%)

0.000

IV immunoglobuline

No

Yes

3093 (96.4%)

120 (3.6%)

414 (90.9%)

41 (9.1%)

0.000

Rituximab

No

Yes

3061 (94.4%)

179 (5.6%)

413 (89.7%)

47 (10.3%)

0.000

Splenectomia

No

Yes

3194 (98.6%)

45 (1.4%)

445 (96.9%)

14 (3.1%)

0.008

Dyalisis

No

Yes

3135 (97.3%)

84 (2.7%)

440 (95.0%)

23 (5%)

0.002

Kidney transplantation

No

Yes

3172 (98.6%)

42 (1.4%)

444 (96.7%)

15 (3.3%)

0.001

Osteoporosis

No

Yes

3085 (92.4%)

252 (7.6%)

455 (96.8%)

15(3.2%)

0.001

Fibromyalgia

No

Yes

3135 (93.3%)

224 (6.7%)

461 (97.6%)

11 (2.4%)

0.000

Anti-Ro Ab

No

Yes

2015 (60.5%)

1315 (39.5%)

310 (66.6%)

155 (33.4%)

0.011

Secondary Sjögren

No

Yes

2850 (84.7%)

508 (15.3%)

447 (93.5%)

31 (6.5%)

0.000

Conclusion: jSLE have higher percentage of nephritis, hypertension (associated with nephritis), anti-DNA, Creat clearance < 5, proteinuria > 3.5, recurrent nephritis, chronic renal failure, organic brain syndrome and thrombotic thrombocytopenic purpura and more SLE family background. jSLE also have higher SLEDAI, Katz, but lower Charlson scores. Secondary Sjögren (anti-RO), fibromyalgia and osteoporosis are more common in aSLE. jSLE receive more steroid treatment, synthetic immunosuppressants, IV immunoglobuline, rituximab, splenectomy, dialysis and kidney transplantation.

Disclosure: T. Salman-Monte, None; V. Torrente-Segarra, None; I. Rúa-Figueroa, None; J. Calvo-Alen, None; F. Lopez Longo, None; M. Galindo, None; J. Pego-Reigosa, Modest; Biocaps (grant 316265 ) of the 7th Framework Programme of the European Union ( FP7 / REGPOT - 2012-2013.1 ) ., FIS ( ISCIII ) PI11 / 02857. C. Other Research Support (supplies, equipment, receipt of drugs or other in-kind support); Modest; GSK , U, 2.

To cite this abstract in AMA style:

Salman-Monte T, Torrente-Segarra V, Rúa-Figueroa I, Calvo-Alen J, Lopez Longo F, Galindo M, Pego-Reigosa J. Clinical and Serological Differences Between Juvenile-Onset and Adult-Onset Systemic LUPUS Erythematosus Patients from a National Registry of Patients [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/clinical-and-serological-differences-between-juvenile-onset-and-adult-onset-systemic-lupus-erythematosus-patients-from-a-national-registry-of-patients/. Accessed .

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-and-serological-differences-between-juvenile-onset-and-adult-onset-systemic-lupus-erythematosus-patients-from-a-national-registry-of-patients/