title: Association of herpes zoster infection with clinical characteristics and MBL2 gene polymorphisms in Chinese children with systemic lupus erythematosus.
abstract: OBJECTIVE
  In the first part of this study, we analyzed clinical factors associated with pediatric-onset systemic lupus erythematosus (SLE), and patient susceptibility to herpes zoster (HZ). In the second part of this study, we characterized MBL2 genotype polymorphisms in pediatric-onset SLE patients and their possible associations with HZ.
  
  
  METHODS
  This 10-year prospective cohort study compared pediatric-onset SLE patients from Taiwan with and without histories of HZ. By using 2 years as a standard interval, patients with early-onset and late-onset of HZ were compared. MBL2 gene polymorphisms in exon 1 at codon 54, and in the promoter at the position -221 and -550, were tested immediately after patient enrollment.
  
  
  RESULTS
  We initially enrolled 98 SLE patients, and analyzed complete clinical characteristics of 82 patients (35 patients with HZ, 47 patients without HZ). The incidence of HZ was higher in SLE patients who had methylprednisolone pulse therapy, cyclophosphamide pulse therapy, and received higher cumulative steroid dose (P < 0.05 for all 3). There were no significant associations of HZ with MBL2 genotype or serum level of mannose-binding lectin.
  
  
  CONCLUSIONS
  Pediatric-onset SLE patients were highly susceptible to HZ, with an incidence of 35.7%. Patients given steroid, cyclophosphamide, and high cumulative steroid dose were more likely to have had HZ. Deficiency of serum mannose-binding lectin and MBL2 gene polymorphism were not associated with HZ.
authors.affiliation: Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Shun-An
authors.initials: SA
authors.lastname: Wu
authors.forename: Kou-Wei
authors.initials: KW
authors.lastname: Yeh
authors.forename: Tsung-Chieh
authors.initials: TC
authors.lastname: Yao
authors.forename: Jing-Long
authors.initials: JL
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006562:Herpes Zoster / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D037601:Mannose-Binding Lectin / Q000235:genetics*; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D013624:Taiwan
chemical_list: D007166:Immunosuppressive Agents; C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin; D013256:Steroids