This is the first description of the incidence and clinical manifestations of jSLE in a cohort of New Zealand children. Although limited by the small numbers involved it confirmed anecdotal suspicions that the incidence of jSLE among Maori, Pacific and Asian children is higher than European children. Lupus nephritis is also more frequent and severe in Maori and Pacific children.

Maori and Pacific Island children were more likely to present with poor prognostic features at diagnosis although the incidence of JIA was demonstrated to be significantly higher among European children compared to all ethnic groups. This article is protected by copyright. All rights reserved.

two pints given to one patient, was unnecessary. Patients were kept inactive for one week after suture removal to avoid hematoma formation in the wound. Under cover of this material these patients behaved as normals.

To describe the incidence, demographics, diagnostic clinical manifestations and long-term outcomes of juvenile dermatomyositis (JDM) in Maori and Pacific Island compared to European children. Methods: A chart review was conducted of children with JDM seen by the Starship Rheumatology service between 2000 and 2020. Diagnostic clinical manifestations, demographics, disease course and significant complications were collated. The incidence, clinical manifestations and severity of JDM were determined and compared between ethnic groups, in particular Maori and Pacific Island, and European children. Results: The overall incidence of JDM was 0.24/100 000 per year with no significant ethnic variation. Maori children were less likely to achieve a clinical response (71 vs. 100%, P = 0.08), Maori and Pacific less likely to achieve clinical remission (56 vs. 40%, P = 0.69), with Maori (71 vs. 44%, P = 0.37) and Maori and Pacific (60 vs. 44%, P = 0.69) children more likely to follow a chronic course compared to European children. Calcinosis (50 vs. 13%, P = 0.07), cutaneous vasculopathy (30 vs. 0%, P = 0.05) and interstitial lung disease (30 vs. 6%, P = 0.26) were more common in Maori and Pacific compared to European children. Conclusion:The incidence of JDM among a cohort of New Zealand children was established, with Maori and Pacific children more likely to experience a chronic continuous disease course, calcinosis, cutaneous vasculopathy and interstitial lung disease compared to European children.

Objective To determine the long-term outcome of Maori and Pacific Island children diagnosed with childhood onset lupus nephritis. Method A chart review was conducted of children diagnosed with biopsy proven lupus nephritis seen by the Starship Hospital and Kidz First paediatric rheumatology and/or Starship renal services between January 1992 and January 2018. Baseline and follow-up kidney histology, adherence and response to therapy including partial or full renal remission, refractory disease, end-stage kidney disease (ESKD) and mortality were determined. Results In a New Zealand cohort of 42 with childhood onset lupus nephritis, Maori and Pacific Island children were significantly more likely to develop class 4 lupus nephritis (RR (95% CI), 11.3 (3.84–49.9), p < 0.0001), demonstrate medication nonadherence (RR (95% CI) 12.4 (3.48–85.7), p < 0.0001) and experience end stage kidney disease (RR (95% CI) 15.7 (2.97–389.3), p = 0.0003) and mortality (RR (95% CI) 11.1 (1.91–280.1), p = 0.005) compared to non-Maori and Pacific Island children. In addition, Maori children with childhood onset lupus nephritis developed chronic histological changes significantly more rapidly than Pacific or Asian children ( p = 0.038). Conclusion Lupus nephritis is more common among Maori and Pacific Island children in New Zealand associated with a significant incidence of end stage kidney disease and mortality, with some Maori children developing rapid histologic disease progression.