Verbal ability impairment in juvenile systemic lupus erythematosus.
OBJECTIVE
Evaluate the frequency of verbal ability impairment and associated factors in patients with juvenile systemic lupus erythematosus (JSLE).


METHODS
Cross sectional study of 36 children and adolescents with JSLE of a group of 57 patients at the Clinic of Rheumatology, Department of Pediatrics and Medical Clinic of Santa Casa de Misericórdia de São Paulo. At the time of diagnosis and study, we analyzed the following epidemiological features: clinical, socioeconomic, and educational level. Patients underwent cognitive and laboratory tests and we assessed disease activity (SLEDAI), cumulative damage (SLICC-DI), and treatment with corticosteroids. The patients underwent cognitive tests (Wechsler Intelligence Scales: WISC III and Waiss III), and the results were evaluated according to epidemiological, clinical, laboratory and treatment features.


RESULTS
The mean age at diagnosis was 11.2 ± 2 years and at the time of the study the mean age was 15.4 ± 4.7 years. There was predominance of women (89%) and of socioeconomic class C patients (61.1%). The cognitive impairment found in these patients was frequent (58.3%), affecting more often the verbal ability. We found association of verbal ability impairment with low socioeconomic status and cumulative damage (P < 0.05), but not with disease activity, presence of autoantibodies, and dose of corticosteroids (P > 0.05).


CONCLUSIONS
Change in verbal ability is frequent in JSLE and is associated with socioeconomic status and cumulative damage, and should be suspected and investigated, particularly in pediatric patients to avoid quality of life impairment in adulthood. As it is not related with disease activity or presence of autoantibodies, it should always be assessed in the presence or absence of these factors. Likewise, the doses of corticosteroids should be independently evaluated.
Faculdade de Ciências Médicas, Santa Casa de São Paulo. carolls@uol.com.br
Maria Carolina
MC
dos Santos
Eunice Mitiko
EM
Okuda
Marcos Vinícius
MV
Ronchezel
Elaine Pires
EP
Leon
Vilma S
VS
Trindade
Wanda Alves
WA
Bastos
Silvana B
SB
Sacchetti
D000293:Adolescent; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D012189:Retrospective Studies; D013064:Speech Disorders / Q000209:etiology*