Childhood systemic lupus erythematosus in Latin America. The GLADEL experience in 230 children.
To evaluate disease characteristics of childhood onset SLE in Latin America and to compare this information with an adult population in the same cohort of GLADEL. A protocol was designed as a multicenter, multinational, inception cohort of lupus patients to evaluate demographic, clinical, laboratory and serological variables, as well as classification criteria, disease activity, organ damage and mortality. Descriptive statistics, chi square, Fisher's exact test, Student's t test and multiple logistic regression were used to compare childhood and adult onset SLE. 230 patients were <18 years and 884 were adult SLE patients. Malar rash, fever, oral ulcers, thrombocytopenia and hemolytic anemia and some neurologic manifestations were more prevalent in children (p<0.05). On the other hand, myalgias, Sjögren's syndrome and cranial nerve involvement were more frequently seen in adults (p<0.05). Afro-Latin-American children had a higher prevalence of fever, thrombocytopenia and hemolytic anemia. White and mestizo children had a higher prevalence of malar rash. Mestizo children had a higher prevalence of cerebrovascular disease and cranial nerve involvement. Children met SLE ACR criteria earlier with higher mean values than adults (p: 0.001). They also had higher disease activity scores (p: 0.01), whereas adults had greater disease damage (p: 0.02). In Latin America, childhood onset SLE seems to be a more severe disease than adults. Some differences can be detected among ethnic groups.
Sección de Reumatología, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia. largo2001co@yahoo.com
L A
LA
Ramírez Gómez
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O
Uribe Uribe
O
O
Osio Uribe
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H
Grisales Romero
M H
MH
Cardiel
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D
Wojdyla
B A
BA
Pons-Estel
Luis J
LJ
Catoggio
Enrique R
ER
Soriano
Patricia M
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Imamura
Jorge A
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Manni
Sebastián
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Grimaudo
Judith
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Sarano
José A
JA
Maldonado-Cocco
Maria S
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Arriola
Graciela
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Gómez
Mercedes A
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García
Ana Inés
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Marcos
Juan Carlos
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Marcos
Hugo R
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Scherbarth
Pilar C
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Marino
Estela L
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Motta
Cristina
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Drenkard
Susana
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Gamron
Sandra
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Buliubasich
Carlos M
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Onetti
Francisco
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Caeiro
Alejandro
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Alvarellos
Verónica
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Saurit
Silvana
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Gentiletti
Norberto
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Quagliatto
Alberto A
AA
Gentiletti
Daniel
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Machado
Marcelo
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Abdala
Simón
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Palatnik
Guillermo A
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Berbotto
Carlos A
CA
Battagliotti
Emilia
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Sato
Elaine M C
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Sella
AlexandreW S
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Souza
Lilian T Lavras
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Costallat
Manoel Barros
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Bertolo
Ibsen Bellini
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Coimbra
Eduardo Ferreira
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Borba Neto
Eloisa
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Bonfá
João Carlos
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Tavares
Brenol
Ricardo
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Xavier
Tamara
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Mucenic
Fernando de Souza
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Cavalcanti
Angela Luzia Branco
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Duarte
Cláudia Diniz Lopes
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Marques
Nilzio Antonio
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Da Silva
Ana Carolina
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de O e Silva
Tatiana Ferracine
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Pacheco
José Fernando
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Molina-Restrepo
Javier
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Molina-López
Antonio
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Iglesias-Gamarra
Antonio
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Iglesias-Rodríguez
Eduardo
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Egea-Bermejo
Renato A
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Guzmán-Moreno
José F
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Restrepo-Suárez
Marlene
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Guibert-Toledano
Gil Alberto
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Reyes-Llerena
Loreto
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Massardo
Néstor
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Gareca
Sergio
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Jacobelli
Oscar J
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Neira
Leonardo R
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Guzmán
Abraham
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Garcia-Kutzbach
Claudia
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Castellanos
Erwin
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Cajas
Virginia
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Pascual-Ramos
Leonor A
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Barile-Fabris
Juan Manuel
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Miranda-Limón
Mary-Carmen
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Amigo
Luis H
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Silveira
Ignacio García
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De La Torre
Gerardo
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Orozco-Barocio
Magali L
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Estrada-Contreras
Maria Josefina Sauza
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del Pozo
Laura E
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Aranda Baca
Adelfia Urenda
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Quezada
Guillermo F
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Huerta-Yáñez
Eduardo M
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Acevedo-Vásquez
José Luis
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Alfaro-Lozano
Jorge M
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Cucho-Venegas
Maria Inés
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Segami
Cecilia P
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Chung
Magaly
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Alva-Linares
Isaac
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Abadi
Rosa
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Chacón-Díaz
Soham
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Al Snih Al Snih
Maria H
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Esteva-Spinetti
Jorge
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Vivas
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D005260:Female; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000503:physiopathology; D008297:Male