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Influence of age at disease onset in the outcome of paediatric systemic lupus erythematosus
Rheumatology, 05/08/09
Descloux E et al. - Study reports that the risk of damage is inversely correlated with age at disease onset in paediatric systemic lupus erythematosus (pSLE). The poorer outcome observed in younger children may be explained by a more severe disease expression, higher infectious susceptibility, and a more aggressive therapy, particularly within the first 6 months of disease course.
Methods- Aim was to investigate the influence of age at disease onset in the outcome of pSLE
- 56 pts; divided into 3 groups: pre-pubertal, peripubertal and post-pubertal onset
- The SDI (SLICC/ACR Damage Index for SLE), pts’ characteristics, disease manifestations and treatments were compared
- Risk of damage (SDI ≥1) decreased when age at disease onset increased
- This excess of risk was found in all disease duration intervals studied and at the end of f/u
- Kaplan–Meier curves indicated a higher and earlier risk of damage in younger pts
- Young children showed higher frequency of autoimmune family history
- Frequency of neuropsychiatric disorders and damages decreased with age at disease onset
- Cumulative duration of high-dose prednisone and number of immunosuppressive drugs used contributed to damage increased when age at disease onset decreased
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