title: Influence of ethnicity on childhood-onset systemic lupus erythematosus: results from a multiethnic multicenter Canadian cohort.
abstract: OBJECTIVE
  To determine the influence of ethnicity and sociodemographic factors on disease characteristics of the Canadian pediatric lupus population.
  
  
  METHODS
  Childhood-onset systemic lupus erythematosus (SLE) patients at 4 pediatric centers in Halifax, Montreal, Toronto, and Vancouver were consecutively recruited. Sociodemographics and disease data were collected. Patients were categorized by their primary self-selected ethnicity, and exploratory cluster analyses were examined for disease expression by ethnicity.
  
  
  RESULTS
  We enrolled 213 childhood-onset SLE patients, and ethnicity data were available for 206 patients: white (31%), Asian (30%), South Asian (15%), black (10%), Latino/Hispanic (4%), Aboriginal (4%), and Arab/Middle Eastern (3%). The frequency of clinical classification criteria (malar rash, arthritis, serositis, and renal disease) and autoantibodies significantly differed among ethnicities. Medications were prescribed equally across ethnicities: 76% were taking prednisone, 86% antimalarials, and 56% required additional immunosuppressants. Cluster analysis partitioned into 3 main groups: mild (n = 50), moderate (n = 82), and severe (n = 68) disease clusters. Only 20% of white patients were in the severe cluster compared to 51% of Asian and 41% of black patients (P = 0.03). However, disease activity indices and damage scores were similar across ethnicities.
  
  
  CONCLUSIONS
  Canadian childhood-onset SLE patients reflect our multiethnic population, with differences in disease manifestations, autoantibody profiles, and severity of disease expression by ethnicity.
authors: Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. deborah.levy@sickkids.ca
authors: Deborah M
authors: DM
authors: Levy
authors: Christine A
authors: CA
authors: Peschken
authors: Lori B
authors: LB
authors: Tucker
authors: Gaëlle
authors: G
authors: Chédeville
authors: Adam M
authors: AM
authors: Huber
authors: Janet E
authors: JE
authors: Pope
authors: Earl D
authors: ED
authors: Silverman
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood; D002170:Canada; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D044469:Racial Groups / Q000706:statistics & numerical data; D012720:Severity of Illness Index
chemical_list: D001323:Autoantibodies