P047 Musculoskeletal symptoms as first clinical presentation of juvenile-onset systemic lupus erythematosus: Experience from a military internal medicine department

Background Juvenile-onset systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder occurring before the age of sixteen. The clinical manifestations are variable and the management of the disease at this age may be different. The aim of our study was to investigate first clinical presentation of juvenile-onset SLE. Methods We conducted a retrospective study in a military internal medicine department. We accessed medical records of 103 patients with SLE diagnosed according to the revised 1997 American College of Rheumatology (ACR) criteria or the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria. Only patients with an age of lupus-onset < the age of sixteen were included. Clinical data were collected and analyzed. The statistical analysis was performed using SPSS 23.0 software. Result There were eight juvenile-onsets SLE: two males and six females. The median age at the diagnosis was 13.7 + 1.9 years-old (11–16). First clinical presentations are shown in table 1. Arthritis and hematological involvement tended to be associated (p = 0.07). Hypocomplementemia and positive anti-DNA antibodies were detected in 50% of cases. All patients received Hydroxychloroquine and most of them combined corticosteroids (7cases). Conclusion Our study showed that musculoskeletal manifestations especially arthritis were frequent at the diagnosis of juvenile-onset SLE. According to the aggressive pharmacological treatment, a multidisciplinary approach should be required