Clinical implications of Antiphospholipid Antibodies and Secondary Antiphospholipid Syndrome in Juvenile-onset Systemic Lupus Erythematosus

Daniel Clemente¹, Alina-Lucica Boteanu², Clara Udaondo³, Joan Calzada⁴, Juan Carlos Nieto⁵, Eugenia Enriquez⁶, Inmaculada Calvo⁷, Lourdes Villalobos⁸, Belen Sevilla⁹, Sara Murias¹⁰, Berta Magallares¹¹, Ana Capilla¹², Jaime Arroyo¹³, Beatriz Bravo¹⁴, Gisela Diez-Cordoves¹⁵, Marisol Camacho¹⁶, Genaro grana¹⁷, Juan Jose Bethencourt¹⁸, Pablo Mesa¹⁹, Natalia Palmou²⁰, Mireia Lopez Corbeto²¹, Judith Sanchez²², Maria Isabel Gonzalez²³, Clara Moriano²⁴, Diego Dios¹⁷, Lorena Exposito²⁵, Alicia Garcia²⁶, Laura Martin²⁷, David Fernandez²⁸, Laura Trujillo¹⁴, Anahy Maria Brandy²⁹, CARLOS GUILLEN-ASTETE³⁰ and lydia Abasolo Alcazar³¹, ¹Hospital Infantil Universitario NIño Jesús, Madrid, Madrid, Spain, ²H.U. Ramón y Cajal, Madrid, Spain, ³La Paz University Hospital, Madrid, Spain, ⁴University Hospital Sant Joan de Deu, Barcelona, Spain, ⁵Hospital General Universitario Gregorio Marañón, Madrid, Spain, ⁶Clínica Universidad de Navarra, Madrid, Spain, ⁷Hospital La Fe, Valencia, Comunidad Valenciana, Spain, ⁸Ramon y Cajal Hospital, MADRID, Spain, ⁹Division of Pediatrics, Hospital Universitario San Cecilio, Granada, Spain, ¹⁰H.U Central de Asturias, Oviedo, Spain, ¹¹Hospital de Sant Pau, Bareclona, ¹²H.U de La Merced, Sevilla, Spain, ¹³HOSPITAL UNIVERSITARIO LA PAZ, MADRID, ¹⁴H.U Virgen de Las Nieves, Granada, Spain, ¹⁵H. R. U. Malaga, Malaga, Spain, ¹⁶H.U. Virgen del Rocío, Sevilla, Spain, ¹⁷H.U de A Coruña, A Coruña, Spain, ¹⁸H.U. Canarias, Canarias, Spain, ¹⁹H.U Virgen de la Arrixaca, Murcia, Spain, ²⁰H.U. marques de Valdecilla, Santander, Spain, ²¹H.U Vall d´Hebron, Barcelona, Spain, ²²Pediatric Rheumatology Department, Taulí Hospital Universitari-Institut d'Investigació i Innovació Parc Taulí (I³PT-CERCA), Sabadell (Spain)., Sabadell, Spain, ²³H.U. La Fé, Valencia, Spain, ²⁴Hospital León, LEON, Castilla y Leon, Spain, ²⁵H.U Canarias, Canarias, Spain, ²⁶Rheumatologist, La Laguna, Spain, ²⁷H.R.U Malaga, Malaga, Spain, ²⁸Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, Spain, ²⁹Hospital Germans Trias i Pujol, Badalona, Spain, ³⁰H.U Ramón y Cajal, Madrid, Spain, ³¹IdISSC. HCSC, Madrid, Madrid, Spain

Meeting: ACR Convergence 2025

Keywords: antiphospholipid syndrome, Pediatric rheumatology, registry, Systemic lupus erythematosus (SLE)

Session Information

Date: Monday, October 27, 2025

Title: (1272–1305) Pediatric Rheumatology – Clinical Poster II

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in juvenile-onset systemic lupus erythematosus (jSLE) patients. We aimed to assess the clinical manifestations of jSLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome (APS).

Methods: Patients from the JULES registry were included. JULES is a Spanish multicenter, hospital-based, retrospective, jSLE registry. Three groups were established: a) SLE without antiphospholipid antibodies (jSLE); b) SLE with antiphospholipid antibodies (jSLE-aPL); c) SLE with secondary antiphospholipid syndrome (jSLE-APS). Clinical manifestations were compared between the 3 groups.

Results: We included 249 patients. 177 patients were classified as jSLE, 50 as jSLE-aPL, and 22 as jSLE-APS. The age of the cases ranged from 5 months to 18 years (mean age 12.65, SD 3.31); 207 patients (83.8%) were female. Regarding cardiovascular risk factors, jSLE-APS patients and jSLE-aPL had higher rates of hypertension and dyslipidemia than those with jSLE (p< 0.001). jSLE-APS patients showed higher rates of neurological manifestations (p< 0.05) and thrombopenia (63% in jSLE-APS, 30% in jSLE-aPL and 21% in jSLE, p< 0.01). The presence of livedo reticularis and Raynaud's syndrome was more frequent in the jSL-aPL group (p< 0.05). There were no differences in pulmonary or cardiac manifestations.Regarding pharmacological treatment, in addition to antiplatelet and anticoagulant therapy, rituximab was used more frequently at the beginning in the jSLE-APS group (p< 0,05) and intravenous immunoglobulins in both jSLE-aPL y jSLE-APS groups (p< 0,01).

Conclusion: jSLE-APS patients exhibited more severe clinical profiles with higher frequencies of major organ involvement than jSLE-aPL and jSLE patients. Further studies are needed to determine the risk and long-term outcomes of aPL-related events.

Disclosures: D. Clemente: GlaxoSmithKlein(GSK), 6; A. Boteanu: GSK, 5, 6; C. Udaondo: None; J. Calzada: None; J. Nieto: None; E. Enriquez: None; I. Calvo: None; L. Villalobos: None; B. Sevilla: None; S. Murias: None; B. Magallares: None; A. Capilla: None; J. Arroyo: None; B. Bravo: None; G. Diez-Cordoves: None; M. Camacho: None; G. grana: None; J. Bethencourt: None; P. Mesa: None; N. Palmou: None; M. Lopez Corbeto: None; J. Sanchez: None; M. Gonzalez: None; C. Moriano: None; D. Dios: None; L. Exposito: None; A. Garcia: None; L. Martin: None; D. Fernandez: None; L. Trujillo: None; A. Brandy: None; C. GUILLEN-ASTETE: None; l. Abasolo Alcazar: None.

To cite this abstract in AMA style:

Clemente D, Boteanu A, Udaondo C, Calzada J, Nieto J, Enriquez E, Calvo I, Villalobos L, Sevilla B, Murias S, Magallares B, Capilla A, Arroyo J, Bravo B, Diez-Cordoves G, Camacho M, grana G, Bethencourt J, Mesa P, Palmou N, Lopez Corbeto M, Sanchez J, Gonzalez M, Moriano C, Dios D, Exposito L, Garcia A, Martin L, Fernandez D, Trujillo L, Brandy A, GUILLEN-ASTETE C, Abasolo Alcazar l. Clinical implications of Antiphospholipid Antibodies and Secondary Antiphospholipid Syndrome in Juvenile-onset Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/clinical-implications-of-antiphospholipid-antibodies-and-secondary-antiphospholipid-syndrome-in-juvenile-onset-systemic-lupus-erythematosus/. Accessed .

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