Gender and ethnic origin have no effect on longterm outcome of childhood-onset systemic lupus erythematosus.
OBJECTIVE
To investigate the associations of gender and ethnic origin with longterm outcome in childhood-onset systemic lupus erythematosus (SLE).


METHODS
The study cohort consisted of 51 patients (13 males and 38 females) with childhood-onset SLE followed for > or = 5 years at the British Columbia Children's Hospital in Vancouver. Fifteen patients were Caucasian, 14 Chinese, 9 East Indian, and 13 patients were of other ethnic backgrounds: none was African-American or Hispanic. Outcome measures assessed retrospectively included Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index score (SDI), SLE-related death, need for dialysis or renal transplantation, and use of intensive immunosuppressive therapy. A SDI > or = 2 was assigned as poor outcome.


RESULTS
The median age at diagnosis was 10.8 years and the median duration of followup was 7.2 years. Five-year survival was 100%; 10-year survival was 85.7% (12/14 patients). The median SDI score at last followup was 2.0 (range 0-9); 2.0 for male, 1.5 for female; 2.0 for Caucasian and 2.03 for non-Caucasian patients. Twenty-six out of 51 patients (51%) had poor outcome (SDI score > 2). Three female patients required dialysis: 2 had subsequent renal transplants. Thirty patients received intensive immunosuppressive therapy. The SDI scores, mortality, and need for intensive immunosuppressive therapy were not influenced by either gender or ethnic origin.


CONCLUSIONS
The median SDI score was high for this cohort with childhood-onset SLE. In contrast to other published data, no association of male gender and/or non-Caucasian ethnicity with poor outcome was found in our study cohort.
Division of Rheumatology, Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
Paivi M
PM
Miettunen
Oliva
O
Ortiz-Alvarez
Ross E
RE
Petty
Rolando
R
Cimaz
Peter N
PN
Malleson
David A
DA
Cabral
Stephanie
S
Ensworth
Lori B
LB
Tucker
D017668:Age of Onset; D044466:Asian People; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007214:Indonesia / Q000208:ethnology; D016030:Kidney Transplantation; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D008297:Male; D017063:Outcome Assessment, Health Care; D006435:Renal Dialysis; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D044465:White People
D007166:Immunosuppressive Agents