Clinical and immunological aspects and outcome of a Brazilian cohort of 414 patients with systemic lupus erythematosus (SLE): comparison between childhood-onset, adult-onset, and late-onset SLE
| Autor: | Át Mendes Ribeiro, M M das Chagas Medeiros, V C do Rosário Rebouças, A C Rodrigues Gois, T M Amorim Zaranza de Carvalho, L N Solon Carvalho, F N Holanda Ferreira Braga, M Campos Bezerra, M R Melo da Justa Feijão |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Late onset Comorbidity Hospitals University Young Adult 03 medical and health sciences 0302 clinical medicine Rheumatology Risk Factors Prednisone Internal medicine Epidemiology Prevalence medicine Humans Lupus Erythematosus Systemic 030212 general & internal medicine Age of Onset Child Glucocorticoids Retrospective Studies 030203 arthritis & rheumatology business.industry Remission Induction Mean age Middle Aged medicine.disease University hospital Lupus Nephritis Frequent use Treatment Outcome Antibodies Antinuclear Child Preschool Immunology Cohort Antibodies Antiphospholipid Disease Progression Female business Nephritis Biomarkers Brazil Immunosuppressive Agents medicine.drug |
| Zdroj: | Lupus. 25:355-363 |
| ISSN: | 1477-0962 0961-2033 |
| DOI: | 10.1177/0961203315606983 |
| Popis: | The clinical expression of systemic lupus erythematosus (SLE) is influenced by genetic and environmental factors and therefore varies between ethnicities. Information on the epidemiology of SLE in Brazil is scarce and practically limited to studies conducted in socioeconomically developed regions (South and Southeast). The objective of this study was to describe the clinical and immunological aspects and outcome of a cohort of patients with SLE treated at a university hospital in northeastern Brazil and compare patterns related to age at onset: childhood (cSLE), adult (aSLE), and late (lSLE). A random sample of 414 records (women: 93.5%) were reviewed. The mean age at SLE onset and the mean disease duration were 28.9 ± 10.9 years and 10.2 ± 6.6 years, respectively. Most patients had aSLE ( n = 338; 81.6%), followed by cSLE ( n = 60; 14.5%) and lSLE ( n = 16; 3.9%). The female/male ratio was 6.5:1 in cSLE and 16.8:1 in aSLE; in lSLE, all patients were female ( p = 0.05). During follow-up, the cSLE group presented higher rates of nephritis (70% vs. 52.9% vs. 12.5%; p = 0.0001) and leuko/lymphopenia (61.7% vs. 43.8% vs. 56.2%; p = 0.02). No significant differences were found for anti-dsDNA, anti-Sm, and antiphospholipid antibodies. Treatment with immunosuppressants was significantly more common, and higher doses of prednisone were used, in cSLE. The prevalence of cardiovascular diseases were more frequent in lSLE ( p = 0.03). No significant differences were found between the three groups with regard to mean damage accrual (SDI), remission, and mortality. Although cSLE presented higher rates of nephritis and leuko/lymphopenia, more frequent use of immunosuppressants and higher prednisone doses than aSLE and lSLE, the three groups did not differ significantly with regard to damage accrual, remission, and mortality. |
| Databáze: | OpenAIRE |
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