title: Similarities and differences between pediatric and adult patients with systemic lupus erythematosus.
abstract: Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease with highest prevalence among women of childbearing age. However, children younger than 16 years also can develop SLE (childhood-onset lupus/juvenile-type SLE). The aim of our study was to compare the clinical course of adult and pediatric-onset SLE. Data from 342 adult patients followed at the University of Debrecen, Hungary, and 79 children documented in the Hungarian National Pediatric SLE registry were analyzed using hospital medical records. Organ manifestations, laboratory parameters, and immunoserological characteristics were reviewed and the results were evaluated using SPSS for Windows software.Gender distribution was not significantly different between groups with disease starting in childhood vs adulthood. The prevalence of the following manifestations was significantly higher for pediatric than for adult-onset disease including: lupus nephritis (43% pediatric vs 26.4% for adult-onset), hematological disorders (57% vs 36.4%), photosensitivity (20% vs 9%), butterfly rash (61% vs 35.5%) and mucosal ulceration (11.4% vs 4%). For adult-onset SLE, neurological symptoms (30% vs 6%) and polyarthritis (86% vs 68%) occurred significantly more frequently than in children. Anti-SSA, anti-SSB and antiphospholipid antibodies were detected at significantly higher levels in adult-onset patients compared to those in pediatrics. Children were more commonly given high-dose intravenous immunoglobulin treatment (6.3% vs 0.6%) and mycophenolate mofetil (15.2% vs 5.3%) than adults.These results suggest that pediatric and adult-onset SLE differ in multiple aspects, and it is important to recognize these differences for optimal treatment and prognosis of these patients.
authors.affiliation: Department of Clinical Immunology, University of Debrecen, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Tarr
authors.affiliation: 2nd. Department of Pediatrics, Semmelweis University Budapest, Hungary Department of Pediatrics, Dalhousie University-IWK Health Centre, Halifax, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Dérfalvi
authors.affiliation: Department of Clinical Immunology, University of Debrecen, Hungary.
authors.forename: N
authors.initials: N
authors.lastname: Győri
authors.affiliation: Department of Clinical Immunology, University of Debrecen, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Szántó
authors.affiliation: Department of Clinical Immunology, University of Debrecen, Hungary.
authors.forename: Z
authors.initials: Z
authors.lastname: Siminszky
authors.affiliation: 1st. Department of Pediatrics and Research Laboratory of Hungarian Academy of Science, Semmelweis University Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Malik
authors.affiliation: 1st. Department of Pediatrics and Research Laboratory of Hungarian Academy of Science, Semmelweis University Budapest, Hungary.
authors.forename: A J
authors.initials: AJ
authors.lastname: Szabó
authors.affiliation: Department of Clinical Immunology, University of Debrecen, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Szegedi
authors.affiliation: Department of Clinical Immunology, University of Debrecen, Hungary zeher@iiibel.dote.hu.
authors.forename: M
authors.initials: M
authors.lastname: Zeher
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood* / Q000145:classification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006814:Hungary; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008181:Lupus Nephritis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult
chemical_list: D001323:Autoantibodies
keywords: SLE; adult; differences; pediatric; similarities