title: Increased incidence of juvenile-onset systemic lupus erythematosus among children with asthma.
abstract: BACKGROUND
  Children with systemic lupus erythematosus (SLE) have an especially aggressive disease course and poor outcomes. Previous studies demonstrated a possible association between SLE and allergies, but the relationship between these disorders remains unclear. This population-based cohort study aimed to investigate the incidence and risk of juvenile-onset SLE (JSLE) among children with asthma.
  
  
  METHODS
  From 2000 to 2003, 120,939 children with newly diagnosed asthma and 483,756 randomly selected non-asthma controls were enrolled. We used a multivariable Cox proportional hazard regression model to measure and compare the incidence rate and risk of JSLE in the asthma and non-asthma cohorts.
  
  
  RESULTS
  The overall incidence of JSLE was 2.52 times greater in the asthma cohort than that in the non-asthma cohort [3.49 vs. 1.53 per 100,000 person-years; 95% confidence interval (CI): 1.59-3.99]. The risk of JSLE was greatest among boys [hazard ratio (HR) 3.02, 95% CI: 1.21-7.52] and children aged 6-10 yr (HR 3.50, 95% CI: 1.75-7.02). The HR of JSLE increased with greater frequency of asthma-related medical visits from 1.22 (95% CI: 0.67-1.41) for those with ≤2 visits/yr to 5.88 (95% CI: 3.43-10.1) for subjects with >2 visits/yr (trend test p < 0.001). However, the risk of JSLE declined over time.
  
  
  CONCLUSIONS
  We found an increased incidence of JSLE among children with asthma. The mechanism of asthma on JSLE development should be elucidated to establish innovative disease intervention programs.
authors: Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors: Chang-Ching
authors: CC
authors: Wei
authors: Cheng-Li
authors: CL
authors: Lin
authors: Te-Chun
authors: TC
authors: Shen
authors: Jeng-Dau
authors: JD
authors: Tsai
authors: Chi-Jung
authors: CJ
authors: Chung
authors: Tsai-Chung
authors: TC
authors: Li
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D012306:Risk; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology
keywords: asthma; juvenile-onset systemic lupus erythematosus