Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescents

<p>Abstract</p> <p>Background</p> <p>Children represent 10-20% of all systemic lupus erythematosus (SLE) patients. Their clinical manifestations and outcomes vary with age. We aim to clarify the relationship between pubescent status and the clinical manifestations of pe...

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Main Authors: Chiang Li-Lan, Lin Yu-Tsan, Chan Hung-Yi, Chiang Bor-Luen
Format: Article
Language:English
Published: BMC 2012-05-01
Series:Pediatric Rheumatology Online Journal
Subjects:
Online Access:http://www.ped-rheum.com/content/10/1/12
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author Chiang Li-Lan
Lin Yu-Tsan
Chan Hung-Yi
Chiang Bor-Luen
author_facet Chiang Li-Lan
Lin Yu-Tsan
Chan Hung-Yi
Chiang Bor-Luen
author_sort Chiang Li-Lan
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Children represent 10-20% of all systemic lupus erythematosus (SLE) patients. Their clinical manifestations and outcomes vary with age. We aim to clarify the relationship between pubescent status and the clinical manifestations of pediatric SLE.</p> <p>Methods</p> <p>In this study, pediatric SLE patients were divided into three groups, based on age at disease onset (≦8, 8–13 & 13–18 years), defined as prepubescent, pubescent and postpubescent, respectively. Initial clinical manifestations and laboratory characteristics at diagnosis were analyzed.</p> <p>Results</p> <p>Ninety-six patients were entered into the study: 8 had disease onset before age 8, while 49 were between 8–13 and 39 of them were 13–18. Female predominance was noted in all three groups (2.5-7.0:1). Postpubescents showed significantly more renal involvement and lymphopenia, along with lower levels of C3 and C4, when compared with prepubescents. They also showed significantly more lymphopenia when compared with pubescents. Pubescents showed significantly more renal involvement, leukopenia and lupus anticoagulant (LAC) positivity, along with lower C3 and C4 levels, when compared with prepubescents. Pubescents also showed significantly higher anti-Sm antibody positivity when compared with postpubescents. Prepubescents showed significantly more splenomegaly and anti-Jo-1 antibody positivity when compared with those of pubescents. The results showed that the disease activity (SLEDAI-2K score) correlated positively with age at disease onset and negatively with disease duration before diagnosis (<it>p</it> = 0.011).</p> <p>Conclusions</p> <p>Age at disease onset is related to initial manifestations in pediatric SLE patients at our center. Certain parameters such as renal involvement, splenomegaly, low C3 level, low C4 level, lymphopenia, leukopenia, and anti-Sm & anti-Jo-1 antibody were found to be significantly different among the age groups. Renal involvement might be the key symptom that varies with age.</p>
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spelling doaj.art-fb445f4db9ee43c49428da970734ac312022-12-21T23:18:15ZengBMCPediatric Rheumatology Online Journal1546-00962012-05-011011210.1186/1546-0096-10-12Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescentsChiang Li-LanLin Yu-TsanChan Hung-YiChiang Bor-Luen<p>Abstract</p> <p>Background</p> <p>Children represent 10-20% of all systemic lupus erythematosus (SLE) patients. Their clinical manifestations and outcomes vary with age. We aim to clarify the relationship between pubescent status and the clinical manifestations of pediatric SLE.</p> <p>Methods</p> <p>In this study, pediatric SLE patients were divided into three groups, based on age at disease onset (≦8, 8–13 & 13–18 years), defined as prepubescent, pubescent and postpubescent, respectively. Initial clinical manifestations and laboratory characteristics at diagnosis were analyzed.</p> <p>Results</p> <p>Ninety-six patients were entered into the study: 8 had disease onset before age 8, while 49 were between 8–13 and 39 of them were 13–18. Female predominance was noted in all three groups (2.5-7.0:1). Postpubescents showed significantly more renal involvement and lymphopenia, along with lower levels of C3 and C4, when compared with prepubescents. They also showed significantly more lymphopenia when compared with pubescents. Pubescents showed significantly more renal involvement, leukopenia and lupus anticoagulant (LAC) positivity, along with lower C3 and C4 levels, when compared with prepubescents. Pubescents also showed significantly higher anti-Sm antibody positivity when compared with postpubescents. Prepubescents showed significantly more splenomegaly and anti-Jo-1 antibody positivity when compared with those of pubescents. The results showed that the disease activity (SLEDAI-2K score) correlated positively with age at disease onset and negatively with disease duration before diagnosis (<it>p</it> = 0.011).</p> <p>Conclusions</p> <p>Age at disease onset is related to initial manifestations in pediatric SLE patients at our center. Certain parameters such as renal involvement, splenomegaly, low C3 level, low C4 level, lymphopenia, leukopenia, and anti-Sm & anti-Jo-1 antibody were found to be significantly different among the age groups. Renal involvement might be the key symptom that varies with age.</p>http://www.ped-rheum.com/content/10/1/12Pediatric systemic lupus erythematosusAgePubescent
spellingShingle Chiang Li-Lan
Lin Yu-Tsan
Chan Hung-Yi
Chiang Bor-Luen
Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescents
Pediatric Rheumatology Online Journal
Pediatric systemic lupus erythematosus
Age
Pubescent
title Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescents
title_full Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescents
title_fullStr Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescents
title_full_unstemmed Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescents
title_short Differential manifestations of prepubescent, pubescent and postpubescent pediatric patients with systemic lupus erythematosus: A retrospective study of 96 Chinese children and adolescents
title_sort differential manifestations of prepubescent pubescent and postpubescent pediatric patients with systemic lupus erythematosus a retrospective study of 96 chinese children and adolescents
topic Pediatric systemic lupus erythematosus
Age
Pubescent
url http://www.ped-rheum.com/content/10/1/12
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