Background/Purpose: Patients with systemic lupus erythematosus (SLE) have a higher thrombotic risk compared to the general population, and arterial and venous thromboses impart substantial morbidity and mortality. Few studies have focused on thrombotic risk within the pediatric SLE (pSLE) population.  We sought to better characterize the risk factors for thrombosis in patients with pSLE utilizing the Childhood Arthritis & Rheumatology Research Alliance (CARRA) registry.

Methods: The CARRA registry contains 979 patients with pSLE. Pediatric SLE patients with a history of thrombosis were compared to those with no history of thrombosis. A history for thrombosis was defined as any patient within the SLE registry who had a history of arterial or venous thrombotic event as reported by the treating pediatric rheumatologist. For continuous variables, the Wilcoxon Mann-Whitney test was used to compare groups. In the case of categorical variables, univariate logistical regression was used to calculate odds ratios (OR). Patients with missing outcome data were excluded from analysis. Statistical Analysis System software 9.3 (SAS Institute Inc., Cary, NC, USA) was used to perform statistical analysis.

Results: Of the 979 patients in the registry, 974 had data recorded for thrombosis and were included in the analysis. The majority of these patients were female (82.4%), non-Hispanic (72.8%) and white (44.7%). Of the 974 patients, 24 (2.5%) had history of arterial thrombosis and 35 (3.6%) of venous thrombosis. Odds ratios for thrombosis were calculated for gender, ethnicity, BMI, race, Raynaud’s phenomenon, vasculitis, avascular necrosis (AVN), renal disease, positive antiphospholipid antibody (APLA), thrombocytopenia, and hydroxychloroquine use. Utilizing a p value of < 0.05 as significant, the odds ratios of having a thrombotic event were significantly higher in patients with vasculitis [3.11, 95% CI: (1.60, 6.01)], history of AVN [3.08, 95% CI: (1.24, 7.67)], or APLA [3.03, 95% CI: (1.45, 6.36)]. Odds ratios for other variables were not statistically significant. 

Conclusion:  Our study of 974 patients with pSLE including 59 with a history of thrombotic event suggests that pSLE patients with a history of vasculitis, positive APLA, and AVN are at a greater risk for thrombotic events than those without. Odds ratios for gender, race, ethnicity, hydroxychloroquine use, renal disease, history of Raynaud’s phenomenon, and thrombocytopenia were not found to be statistically significant within this subset of patients.

---

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/analysis-of-risk-factors-for-thrombosis-in-pediatric-patients-with-systemic-lupus-erythematosus/