Disease duration, hypertension and medication requirements are associated with organ damage in childhood-onset systemic lupus erythematosus

To investigate the frequency of organ damage in childhood-onset systemic lupus erythematosus (SLE) and to identify disease variables and patient characteristics related to organ damage. A cohort of 71 patients was examined in a cross-sectional study after a mean disease duration of 10.8+/-8.2 years...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2005-03, Vol.23 (2), p.261-269
Main Authors: LILLEBY, V, FLATØ, B, FØRRE, Ø
Format: Article
Language:English
Subjects:
Adolescent
Age of Onset
Biological and medical sciences
Cross-Sectional Studies
Cyclophosphamide - adverse effects
Cyclophosphamide - therapeutic use
Female
Glucocorticoids - therapeutic use
Health Status
Humans
Hypertension - etiology
Hypertension - pathology
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Lupus Nephritis - epidemiology
Lupus Nephritis - etiology
Lupus Nephritis - pathology
Lupus Vasculitis, Central Nervous System - epidemiology
Lupus Vasculitis, Central Nervous System - etiology
Lupus Vasculitis, Central Nervous System - pathology
Male
Medical sciences
Musculoskeletal Diseases - epidemiology
Musculoskeletal Diseases - etiology
Musculoskeletal Diseases - pathology
Norway - epidemiology
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Severity of Illness Index
Time Factors
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Summary:To investigate the frequency of organ damage in childhood-onset systemic lupus erythematosus (SLE) and to identify disease variables and patient characteristics related to organ damage. A cohort of 71 patients was examined in a cross-sectional study after a mean disease duration of 10.8+/-8.2 years (mean age 26.4+/-9.8 years). The occurrence of organ damage was measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Factors analysed as possible explanatory variables of organ damage were the following: demographic variables, clinical variables at diagnosis and during disease course, as well as medication use. Growth and self-reported health status were also measured. The most frequent areas of organ damage were in the neuropsychiatric (28%), renal (13%) and musculoskeletal (13%) organ systems. Forty-three patients (61%) had evidence of damage. The mean SDI score was 1.3 for the whole study population. Hypertension, longer disease duration and use of cyclophosphamide were factors significantly related to an increasing SDI score in multiple linear regression analyses. Furthermore, patients with damage (SDI > or =1) compared to those without damage (SDI = 0) had a significantly higher cumulative corticosteroid dose (24.7 g versus 10.6 g) and more frequently required high-dose prednisolone at diagnosis (68% versus 43%). Evidence of organ damage was found in 61% of all patients. Long disease duration, known hypertension and use of cylophosphamide were significantly associated with an increasing SDI score. Furthermore high-dose prednisolone at diagnosis and cumulative prednisolone dose were significantly related to the presence of organ damage.
ISSN:0392-856X
1593-098X