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Demographic Presentation, Activity Indices, Damage Index: Comparative Study Between Pediatric Lupus Erythematosus Versus Adult Systemic Lupus Erythematosus in Sample Egyptian Population

Received: 16 January 2016    Accepted: 26 January 2016    Published: 16 February 2016
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Abstract

Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect all organ systems due to alterations of both the innate and adaptive immune systems. Although onset during infancy is rare, the incidence of SLE rises steadily during childhood until mid-adulthood, especially among females. In this study we aimed to highlight the possible discrepancies in clinical presentations as well as serological profiles of pediatric and adult onset SLE patients, we also focused attention on the disease assessment by SLE activity index (SLE DDI) and damage index at time of presentation. Subjects were subdivided into 2 groups: Group I: A total of 92 Pediatric systemic lupus erythematosus (pSLE) that were selected from the students attending the school children hospital of medical health insurance. Group II: A total of 90 adult systemic lupus erythematosus (aSLE) patients and were recruited from those attending the Alexandria Main University Hospital and outpatient clinic. All patients were subjected to: detailed history taking and complete physical and mental examination, also activity indices as well as damage index were applied for every lupus patient of the studied groups, laboratory investigations were done for all patients. Our results demonstrated that, regarding mucocutaneous manifestations: pSLE patients have values higher than aSLE patients regarding photosensitivity (63.3% and 61.1%) and vascular lesions (23.9% and 22.2%) respectively. Regarding haematological manifestations: pSLE patients have values higher than aSLE patients regarding anemia (86.96% and 84.4), leucopenia (28.3% and 22.22) and thrombocytopenia (46.7% and 25.56%) respectively. Regarding renal abnormalities, pSLE patients have higher incidence of nephritic syndrome than aSLE patients. Regarding SLEDAI, pSLE patients have values statistically higher than aSLE patients. Regarding SLAM, pSLE patients have values statistically higher than aSLE patients, while no differences of damage index was noticed.

Published in American Journal of Internal Medicine (Volume 4, Issue 1)
DOI 10.11648/j.ajim.20160401.13
Page(s) 12-18
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Demographic Presentation, Adult SLE, Pediatric SLE, Activity Indices, Damage Index

References
[1] Olowu W. Childhood-onset systemic lupus erythematosus. J Natl Med Assoc. 2007; 99(7): 777–84.
[2] Brunner HI, Gladman DD, Ibanez D, Urowitz MD, Silverman ED. Difference in disease features between childhood-onset and adult-onset systemic lupus erythematosus. Arthritis Rheum. 2008; 58(2): 556–62.
[3] Al Salloum AA. Lupus nephritis in childhood. Saudi J Kidney Dis Transpl. 2003; 14(1): 43–56.
[4] Padovan M, Govoni M, Castellino G, Rizzo N, Fotinidi M, Trotta F. Late onset systemic lupus erythematosus: no substantial differences using different cut-off ages. Rheumatol Int. 2007; 27(8): 735–41.
[5] Kurahara DK, Grandinetti A, Fujii LL, Tokuda AA, Galario JA, Han MJ, et al. Visiting consultant clinics to study prevalence rates of juvenile rheumatoid arthritis and childhood systemic lupus erythematosus across dispersed geographic areas. J Rheumatol. 2007; 34(2): 425–9.
[6] Rina M, Hermine IB. Pediatric lupus-are there differences in presentation, genetics, response to therapy, damage accrual compared to adult lupus?. Rheum Dis Clin North Am. 2010; 36(1): 53-80.
[7] Tucker LB, Uribe AG, Fernandez M, Vila LM, McGwin G, Apte M, et al. Adolescent onset of lupus results in more aggressive disease and worse outcomes: results of a nested matched case-control study within LUMINA, a multiethnic US cohort (LUMINA LVII) Lupus. 2008; 17(4): 314–22.
[8] Bastian HM, Alarcon GS, Roseman JM, McGwin G, Jr, Vila LM, Fessler BJ, et al. Systemic lupus erythematosus in a multiethnic US cohort (LUMINA) XL II: factors predictive of new or worsening proteinuria. Rheumatology (Oxford) 2007; 46(4): 683–9.
[9] Michelle Petri, Ana-Maria Orbai, Graciela S. Alarcón, Caroline Gordon, Joan T. Merrill, Paul R. Fortin, et al. Derivation and Validation of Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheum. 2012; 64(8): 2677–2686.
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[11] Griffiths B, Mossca M, Gordon C. Assessment of patients with systemic lupus erythematosus and the use of lupus disease activity indices. Best pract Res Clin Rheumatol 2005; 19(5): 685-708.
[12] Gladman D, Grinzler E, Gold Smith C. The development and initial validation of SLE DDI ACR index for systemic lupus. Arthritis Rheum 1997; 40: 809-13.
[13] Liu Z, Davidson A. Taming lupus-a new understanding of pathogenesis is leading to clinical advances. Nat Med. 2012; 18(6): 871-882.
[14] Yacoub Wasef SZ. Gender differences in systemic lupus erythematosus. Gend Med. 2004; 1(1): 12-7.
[15] Farber HW, Foreman AJ, Miller DP, et al. REVEAL registry: correlation of right heart catheterization and echocardiography in patients with pulmonary arterial hypertension. Congest Heart Fail 2011; 17: 56–64.
[16] Jurencak R, Fritzler M, Tyrrell P, et al. Autoantibodies in pediatric systemic lupus erythematosus: ethnic grouping, cluster analysis, and clinical correlations. J Rheumatol. 2009; 36: 416–21.
[17] Deen ME, Porta G, Fiorot FJ, et al. Autoimmune hepatitis and juvenile systemic lupus erythematosus. Lupus. 2009; 18: 747–51.
[18] Deborah ML, Sylvia K. Systemic lupus erythematosus in children and adolescents. Pediatr Clin North Am. 2012; 59(2): 345-364.
[19] Tarr T, Dérfalvi B, Győri N, Szántó A, Siminszky Z, Malik A, Szabó AJ, Szegedi G, Zeher M. Similarities and differences between pediatric and adult patients with systemic lupus erythematosus. Lupus. 2015; 24(8): 796-803.
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    Eman Hassan Elsayed Hassan, Amira Hassan El-Gerby. (2016). Demographic Presentation, Activity Indices, Damage Index: Comparative Study Between Pediatric Lupus Erythematosus Versus Adult Systemic Lupus Erythematosus in Sample Egyptian Population. American Journal of Internal Medicine, 4(1), 12-18. https://doi.org/10.11648/j.ajim.20160401.13

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    ACS Style

    Eman Hassan Elsayed Hassan; Amira Hassan El-Gerby. Demographic Presentation, Activity Indices, Damage Index: Comparative Study Between Pediatric Lupus Erythematosus Versus Adult Systemic Lupus Erythematosus in Sample Egyptian Population. Am. J. Intern. Med. 2016, 4(1), 12-18. doi: 10.11648/j.ajim.20160401.13

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    AMA Style

    Eman Hassan Elsayed Hassan, Amira Hassan El-Gerby. Demographic Presentation, Activity Indices, Damage Index: Comparative Study Between Pediatric Lupus Erythematosus Versus Adult Systemic Lupus Erythematosus in Sample Egyptian Population. Am J Intern Med. 2016;4(1):12-18. doi: 10.11648/j.ajim.20160401.13

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  • @article{10.11648/j.ajim.20160401.13,
      author = {Eman Hassan Elsayed Hassan and Amira Hassan El-Gerby},
      title = {Demographic Presentation, Activity Indices, Damage Index: Comparative Study Between Pediatric Lupus Erythematosus Versus Adult Systemic Lupus Erythematosus in Sample Egyptian Population},
      journal = {American Journal of Internal Medicine},
      volume = {4},
      number = {1},
      pages = {12-18},
      doi = {10.11648/j.ajim.20160401.13},
      url = {https://doi.org/10.11648/j.ajim.20160401.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20160401.13},
      abstract = {Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect all organ systems due to alterations of both the innate and adaptive immune systems. Although onset during infancy is rare, the incidence of SLE rises steadily during childhood until mid-adulthood, especially among females. In this study we aimed to highlight the possible discrepancies in clinical presentations as well as serological profiles of pediatric and adult onset SLE patients, we also focused attention on the disease assessment by SLE activity index (SLE DDI) and damage index at time of presentation. Subjects were subdivided into 2 groups: Group I: A total of 92 Pediatric systemic lupus erythematosus (pSLE) that were selected from the students attending the school children hospital of medical health insurance. Group II: A total of 90 adult systemic lupus erythematosus (aSLE) patients and were recruited from those attending the Alexandria Main University Hospital and outpatient clinic. All patients were subjected to: detailed history taking and complete physical and mental examination, also activity indices as well as damage index were applied for every lupus patient of the studied groups, laboratory investigations were done for all patients. Our results demonstrated that, regarding mucocutaneous manifestations: pSLE patients have values higher than aSLE patients regarding photosensitivity (63.3% and 61.1%) and vascular lesions (23.9% and 22.2%) respectively. Regarding haematological manifestations: pSLE patients have values higher than aSLE patients regarding anemia (86.96% and 84.4), leucopenia (28.3% and 22.22) and thrombocytopenia (46.7% and 25.56%) respectively. Regarding renal abnormalities, pSLE patients have higher incidence of nephritic syndrome than aSLE patients. Regarding SLEDAI, pSLE patients have values statistically higher than aSLE patients. Regarding SLAM, pSLE patients have values statistically higher than aSLE patients, while no differences of damage index was noticed.},
     year = {2016}
    }
    

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  • TY  - JOUR
    T1  - Demographic Presentation, Activity Indices, Damage Index: Comparative Study Between Pediatric Lupus Erythematosus Versus Adult Systemic Lupus Erythematosus in Sample Egyptian Population
    AU  - Eman Hassan Elsayed Hassan
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    DO  - 10.11648/j.ajim.20160401.13
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
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    AB  - Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect all organ systems due to alterations of both the innate and adaptive immune systems. Although onset during infancy is rare, the incidence of SLE rises steadily during childhood until mid-adulthood, especially among females. In this study we aimed to highlight the possible discrepancies in clinical presentations as well as serological profiles of pediatric and adult onset SLE patients, we also focused attention on the disease assessment by SLE activity index (SLE DDI) and damage index at time of presentation. Subjects were subdivided into 2 groups: Group I: A total of 92 Pediatric systemic lupus erythematosus (pSLE) that were selected from the students attending the school children hospital of medical health insurance. Group II: A total of 90 adult systemic lupus erythematosus (aSLE) patients and were recruited from those attending the Alexandria Main University Hospital and outpatient clinic. All patients were subjected to: detailed history taking and complete physical and mental examination, also activity indices as well as damage index were applied for every lupus patient of the studied groups, laboratory investigations were done for all patients. Our results demonstrated that, regarding mucocutaneous manifestations: pSLE patients have values higher than aSLE patients regarding photosensitivity (63.3% and 61.1%) and vascular lesions (23.9% and 22.2%) respectively. Regarding haematological manifestations: pSLE patients have values higher than aSLE patients regarding anemia (86.96% and 84.4), leucopenia (28.3% and 22.22) and thrombocytopenia (46.7% and 25.56%) respectively. Regarding renal abnormalities, pSLE patients have higher incidence of nephritic syndrome than aSLE patients. Regarding SLEDAI, pSLE patients have values statistically higher than aSLE patients. Regarding SLAM, pSLE patients have values statistically higher than aSLE patients, while no differences of damage index was noticed.
    VL  - 4
    IS  - 1
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Author Information
  • Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

  • Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

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