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.
Ramírez Gómez
L A
LA
Sección de Reumatología, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia. largo2001co@yahoo.com
Uribe Uribe
O
O
Osio Uribe
O
O
Grisales Romero
H
H
Cardiel
M H
MH
Wojdyla
D
D
Pons-Estel
B A
BA
Catoggio
Luis J
LJ
Soriano
Enrique R
ER
Imamura
Patricia M
PM
Manni
Jorge A
JA
Grimaudo
Sebastián
S
Sarano
Judith
J
Maldonado-Cocco
José A
JA
Arriola
Maria S
MS
Gómez
Graciela
G
García
Mercedes A
MA
Marcos
Ana Inés
AI
Marcos
Juan Carlos
JC
Scherbarth
Hugo R
HR
Marino
Pilar C
PC
Motta
Estela L
EL
Drenkard
Cristina
C
Gamron
Susana
S
Buliubasich
Sandra
S
Onetti
Carlos M
CM
Caeiro
Francisco
F
Alvarellos
Alejandro
A
Saurit
Verónica
V
Gentiletti
Silvana
S
Quagliatto
Norberto
N
Gentiletti
Alberto A
AA
Machado
Daniel
D
Abdala
Marcelo
M
Palatnik
Simón
S
Berbotto
Guillermo A
GA
Battagliotti
Carlos A
CA
Sato
Emilia
E
Sella
Elaine M C
EM
Souza
AlexandreW S
AS
Costallat
Lilian T Lavras
LT
Bertolo
Manoel Barros
MB
Coimbra
Ibsen Bellini
IB
Borba Neto
Eduardo Ferreira
EF
Bonfá
Eloisa
E
Tavares
João Carlos
JC
Brenol
Xavier
Ricardo
R
Mucenic
Tamara
T
Cavalcanti
Fernando de Souza
Fde S
Duarte
Angela Luzia Branco
AL
Marques
Cláudia Diniz Lopes
CD
Da Silva
Nilzio Antonio
NA
de O e Silva
Ana Carolina
AC
Pacheco
Tatiana Ferracine
TF
Molina-Restrepo
José Fernando
JF
Molina-López
Javier
J
Iglesias-Gamarra
Antonio
A
Iglesias-Rodríguez
Antonio
A
Egea-Bermejo
Eduardo
E
Guzmán-Moreno
Renato A
RA
Restrepo-Suárez
José F
JF
Guibert-Toledano
Marlene
M
Reyes-Llerena
Gil Alberto
GA
Massardo
Loreto
L
Gareca
Néstor
N
Jacobelli
Sergio
S
Neira
Oscar J
OJ
Guzmán
Leonardo R
LR
Garcia-Kutzbach
Abraham
A
Castellanos
Claudia
C
Cajas
Erwin
E
Pascual-Ramos
Virginia
V
Barile-Fabris
Leonor A
LA
Miranda-Limón
Juan Manuel
JM
Amigo
Mary-Carmen
MC
Silveira
Luis H
LH
De La Torre
Ignacio García
IG
Orozco-Barocio
Gerardo
G
Estrada-Contreras
Magali L
ML
del Pozo
Maria Josefina Sauza
MJ
Aranda Baca
Laura E
LE
Quezada
Adelfia Urenda
AU
Huerta-Yáñez
Guillermo F
GF
Acevedo-Vásquez
Eduardo M
EM
Alfaro-Lozano
José Luis
JL
Cucho-Venegas
Jorge M
JM
Segami
Maria Inés
MI
Chung
Cecilia P
CP
Alva-Linares
Magaly
M
Abadi
Isaac
I
Chacón-Díaz
Rosa
R
Al Snih Al Snih
Soham
S
Esteva-Spinetti
Maria H
MH
Vivas
Jorge
J
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