Systemic Lupus Erythematosus in the First Decade of Life

To evaluate whether the onset of systemic lupus erythematosus in the first decade of life was Associated with a unique pattern of racial preponderance, sexual preponderance, genetic predisposition, or disease expression, the medical records of 23 children with systemic lupus erythematosus prior to their tenth birthdays were compared with the medical records of 82 children in whom lupus was diagnosed between their tenth and 20th birthdays. No statistically significant differences in sex distribution, racial (ethnic) background, family history, mode of onset, morbidity, or mortality rates were found between the two age groups. The frequently held view that children with early-onset lupus do worse probably relates to the fact that even though they survive as long as children with the older-onset disease, they die younger because they have the onset of their lupus at a younger age.

Download Full-text

POS0774 INFLUENZA INFECTION AS A TRIGGER FOR SYSTEMIC LUPUS ERYTHEMATOSUS FLARES RESULTING IN HOSPITALIZATION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3409 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 641.1-641

Author(s):

Y. B. Joo ◽

Y. J. Park

Keyword(s):

Systemic Lupus Erythematosus ◽

Confidence Interval ◽

Lupus Erythematosus ◽

Influenza Infection ◽

Age Groups ◽

Case Series ◽

Incidence Rates ◽

Systemic Lupus ◽

Control Interval ◽

The Impact

Background:Infections have been associated with a higher risk of systemic lupus erythematosus (SLE) flares, but the impact of influenza infection on SLE flares has not been evaluated.Objectives:We evaluated the association between influenza infection and SLE flares resulting in hospitalization.Methods:SLE flares resulting in hospitalization and influenza cases were ascertained from the Korean national healthcare insurance database (2014-2018). We used a self-controlled case series design. We defined the risk interval as the first 7 days after the influenza index date and the control interval was defined as all other times during the observation period of each year. We estimated the incidence rates of SLE flares resulting in hospitalization during the risk interval and control interval and compared them using a Poisson regression model.Results:We identified 1,624 influenza infections among the 1,455 patients with SLE. Among those, there were 98 flares in 79 patients with SLE. The incidence ratio (IR) for flares during the risk interval as compared with the control interval was 25.75 (95% confidence interval 17.63 – 37.59). This significantly increased the IRs for flares during the risk interval in both women (IR 27.65) and men (IR 15.30), all age groups (IR 17.00 – 37.84), with and without immunosuppressive agent (IR 24.29 and 28.45, respectively), and with and without prior respiratory diseases (IR 21.86 and 26.82, respectively).Conclusion:We found significant association between influenza infection and SLE flares resulting in hospitalization. Influenza infection has to be considered as a risk factor for flares in all SLE patients regardless of age, sex, medications, and comorbidities.References:[1]Kwong, J. C. et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med 2018:378;345-353.Table 1.Incidence ratios for SLE flares resulting in hospitalization after influenza infectionRisk intervalIncidence ratio95% CIDuring risk interval for 7 days / control interval25.7517.63 – 37.59Days 1-3 / control interval21.8114.71 – 32.35Days 4-7 / control interval7.563.69 – 15.47SLE, systemic lupus erythematosus; CI, confidence intervalDisclosure of Interests:None declared

Download Full-text

Cytomegaloviral or Pneumocystis Jiroveci Pneumonia Increases Mortality in Systemic Lupus Erythematosus Patients with Pulmonary Hemorrhage: Evidence from Bronchoalveolar Lavage Fluid

The Journal of Rheumatology ◽

10.3899/jrheum.180104 ◽

2018 ◽

Vol 46 (3) ◽

pp. 251-258 ◽

Cited By ~ 3

Author(s):

Yi-Syuan Sun ◽

De-Feng Huang ◽

Fang-Chi Lin ◽

Chih-Kai Hsu ◽

I-Ting Sun ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Bronchoalveolar Lavage ◽

Lupus Erythematosus ◽

Bronchoalveolar Lavage Fluid ◽

Pulmonary Hemorrhage ◽

Lavage Fluid ◽

Mortality Rates ◽

Systemic Lupus ◽

Pneumocystis Jiroveci

Objective.To evaluate the role of cytomegaloviral or Pneumocystis jiroveci pneumonia (CMV/PJP) in systemic lupus erythematosus (SLE) patients with pulmonary hemorrhage (PH).Methods.We retrospectively examined hospital records for 27 SLE patients with PH who received bronchoalveolar lavage fluid (BALF) analyses. Clinical profile and mortality rates were compared between groups with and without CMV/PJP. Risk factors for PH-related mortality were analyzed.Results.Among 27 SLE patients with PH, 15 had pathogens from BALF samples, and 8 had CMV/PJP. Although CMV/PJP was treated, the RR for 90- and 180-day mortality rates of SLE patients with CMV/PJP were higher than those without these infections (5.94, 95% CI 1.44–24.48; 7.13, 95% CI 1.81–28.06, respectively). Risk factors for 90- and 180-day mortality were presence of CMV/PJP (OR 14.2, 95% CI 1.83–109.9; OR 25.5, 95% CI 2.91–223.3, respectively) and use of pulse methylprednisolone for PH treatment (OR 12.0, 95% CI 1.48–97.2; OR 8.5, 95% CI 1.13–63.9, respectively). Factors increasing the 90-day mortality rate were duration of mechanical ventilation exceeding 14 days (OR 11.1, 95% CI 1.11–112.0) and use of aggressive immunosuppression close to PH onset (OR 7.56, 95% CI 1.09–52.4). Three of the 7 patients receiving aggressive immunosuppression died with the presence of CMV/PJP.Conclusion.Owing to the high prevalence of CMV/PJP and its association with mortality, routine BALF analysis is recommended for all suitable SLE patients with PH. Use of aggressive immunosuppression does not benefit SLE patients with opportunistic infections during PH attack.

Download Full-text

THU0671 Standardised mortality rates for systemic lupus erythematosus in western australia from 1980 to 2015

10.1136/annrheumdis-2018-eular.6142 ◽

2018 ◽

Author(s):

W.D. Raymond ◽

D. Preen ◽

H. Keen ◽

C. Inderjeeth ◽

J. Nossent

Keyword(s):

Systemic Lupus Erythematosus ◽

Western Australia ◽

Lupus Erythematosus ◽

Mortality Rates ◽

Systemic Lupus

Download Full-text

Factors associated with pericardial effusion in pediatric systemic lupus erythematosus

Paediatrica Indonesiana ◽

10.14238/pi58.5.2018.227-32 ◽

2018 ◽

Vol 58 (5) ◽

pp. 227-32

Author(s):

Pediana Rachmawati ◽

Indah K. Murni ◽

Sasmito Nugroho ◽

Noormanto Noormanto ◽

Sumadiono Sumadiono

Keyword(s):

Systemic Lupus Erythematosus ◽

Pericardial Effusion ◽

Hemolytic Anemia ◽

Lupus Erythematosus ◽

Medical Records ◽

Multivariate Logistic Regression Analysis ◽

Systemic Lupus ◽

Cross Sectional ◽

Pediatric Systemic Lupus Erythematosus ◽

Factors Associated

Background Cardiovascular involvement in systemic lupus erythematosus (SLE) has been reported to range from 4-78%. Complications can affect all structures of the heart, including the endocardium, myocardium, pericardium, and valves. Pericarditis is the most common manifestation, with an incidence of 11-54% in SLE patients. Pericardial effusion is often observed in patients with pericarditis, and can be confirmed by echocardiography. Objective To determine factors associated with pericardial effusion in children with SLE. Methods We conducted a restrospective cross-sectional study by reviewing medical records of children with SLE aged less than 18 years who underwent echocardiography at the Dr. Sardjito Hospital. Yogyakarta, from January 2011 to March 2018. Patients with congenital heart disease or incomplete medical records were excluded. A multivariate logistic regression analysis was done to determine factors that independetly associated with pericardial effusion. Results Among 165 children with SLE, 73 fulfilled the inclusion criteria. The prevalence of pericardial effusion was 54.8%. Median age was 13 (range 5-17) years and the female-to-male ratio was 8:1. Hemolytic anemia (OR=4.135; 95%CI 1.039 to 16.453; P=0.044) was significantly associated with pericardial effusion. Conclusion Hemolytic anemia is significantly associated with pericardial effusion in children with SLE.

Download Full-text

Renal damage in systemic lupus erythematosus: a comparative analysis of different age groups

Lupus ◽

10.1177/0961203306074469 ◽

2007 ◽

Vol 16 (1) ◽

pp. 28-34 ◽

Cited By ~ 53

Author(s):

A Mak ◽

C C Mok ◽

W P Chu ◽

C H To ◽

S N Wong ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Comparative Analysis ◽

Lupus Erythematosus ◽

Renal Damage ◽

Age Groups ◽

Systemic Lupus

Download Full-text

Racial/ethnic variation in stroke rates and risks among patients with systemic lupus erythematosus

Seminars in Arthritis and Rheumatism ◽

10.1016/j.semarthrit.2018.07.012 ◽

2019 ◽

Vol 48 (5) ◽

pp. 840-846 ◽

Cited By ~ 4

Author(s):

Medha Barbhaiya ◽

Candace H. Feldman ◽

Hongshu Guan ◽

Sarah K. Chen ◽

Michael A. Fischer ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Ethnic Variation ◽

Systemic Lupus ◽

Racial Ethnic

Download Full-text

Erratum to Renal damage in systemic lupus erythematosus: a comparative analysis of different age groups

Lupus ◽

10.1177/096120330701600213 ◽

2007 ◽

Vol 16 (2) ◽

pp. 149-149

Keyword(s):

Systemic Lupus Erythematosus ◽

Comparative Analysis ◽

Lupus Erythematosus ◽

Renal Damage ◽

Age Groups ◽

Systemic Lupus

Download Full-text

Predictors of mortality in children with systemic lupus erythematosus

Paediatrica Indonesiana ◽

10.14238/pi59.1.2019.1-6 ◽

2019 ◽

Vol 59 (1) ◽

pp. 1-6

Author(s):

Fanny Listiyono ◽

Indah K. Murni ◽

Sumadiono Sumadiono ◽

Cahya Dewi Satria

Keyword(s):

Systemic Lupus Erythematosus ◽

Logistic Regression ◽

Regression Analysis ◽

Lupus Erythematosus ◽

Medical Records ◽

Bivariate Analysis ◽

Systemic Lupus ◽

Sledai Score ◽

Predictors Of Mortality ◽

One Year

Background Systemic lupus erythematosus (SLE) is a multisystem chronic disease with a relatively high mortality rate in children, despite improvements in prognosis and survival rate over the past decade. Studies on the predictors of mortality in children with SLE, especially in low- and middle-income countries, are limited. Objective To determine the predictors of mortality of children with SLE. Methods This was case-control study using data from medical records of children with SLE at Dr. Sardjito Hospital, Yogyakarta, Indonesia, between 2009 and 2017. Subjects were children aged <18 years diagnosed with SLE. Cases were those who died within one year of diagnosis; the controls were those who were discharged alive. From subjects’ medical records, we collected clinical data including age, sex, date of diagnosis, nutritional status, anti-dsDNA antibody, antinuclear antibody (ANA), hypertension, disease activity based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, proteinuria, thrombocytopenia, mortality/survival outcome, date of death, cause of death, and clinical data including fever, seizures, antibiotic used, microbial culture outcomes, and infection-related diagnoses. We performed bivariate analysis of the association between predictor variables (SLEDAI score, proteinuria, infection, hypertension, and seizures) and mortality outcome (survival or death), followed by logistic regression analysis. Results Eighty-four patients with SLE were included, of which 72 were female. Median age at diagnosis was 14 (range 4-18) years. Twenty-three patients (27%) died within one year after diagnosis. The most common causes of death were infection and renal failure in 8/23 and 7/23 subjects, respectively. On bivariate analysis, the variables significantly associated with mortality were hypertension (OR 3.34, 95%CI 1.22 to 9.14) and infection (OR 3.71; 95%CI 1.36 to 10.12). Seizures, proteinuria, and SLEDAI score were not found to be significantly associated with mortality. On logistic regression analysis, infection was the only significant predictor of mortality (OR 3.22; 95%CI 1.15 to 9.05). Conclusion Among the factors studied, infection is significantly associated with mortality in children with SLE.

Download Full-text