A comparison of the outcome of adolescent and adult-onset systemic lupus erythematosus

Abstract

Adolescent-onset SLE is associated with a significantly increased risk of LN and, importantly, with a marked increase in mortality. These data suggest a more aggressive phenotype of disease in patients with onset of SLE in adolescence and supports the need for intensive follow-up and intensive therapy in this population.

Comparison of clinical and serological differences among juvenile-, adult-, and late-onset systemic lupus erythematosus in Korean patients

“…36 Furthermore, Amaral et al reported no difference in the anti-dsDNA profiles of adolescent-and adult-onset SLE patients. 34 However, our data revealed a higher proportion of positive values for anti-dsDNA and anti-nucleosome antibodies in the JSLE group compared with the other groups, which may be related to the high prevalence of lupus nephritis in the JSLE patients.…”

“…These findings are in line with UK and Taiwanese studies. 34,35 Our study showed distinct features in autoantibodies profile with other ethnic studies. Other studies, on other ethnic groups, did not report an extensive autoantibodies profile, and did not include anti-nucleosome antibody results.…”

Childhood lupus nephritis: 12 years of experience from a developing country’s perspective

“…Lupus nephritis is seen in nearly 50% patients with pediatric-onset SLE (pSLE), which may manifest as asymptomatic urinary findings, acute kidney injury, and even chronic renal disease (5). Renal involvement remains one of the important factors influencing management and long-term prognosis of pSLE (6)(7)(8)(9). There is some evidence that the prognosis of lupus nephritis in developing countries is worse than that in developed countries (10).…”

Why are kids with lupus at an increased risk of cardiovascular disease?

“…Pediatric data has consistently shown that patients with JSLE have a higher incidence of lupus nephritis (LN), arthritis, neurological manifestations, and hematological involvement [6][7][8]. Half of the patients with JSLE will present in adolescence and the median time from symptom onset to diagnosis is 3.2 months, reflecting the difficulty of diagnosing a rare, multisystem disorder with frequently nonspecific symptoms at presentation.…”

“…Despite the improvements in outcomes for adult-onset SLE, patients with JSLE continue to have a lower life expectancy than the general population and in comparison to adults with SLE [7,[9][10][11] 5-year patient survival has improved from 64 to 87 % in the 1980s to greater than 95 % today, with a higher quality of life for patients living with SLE. However, similar to many chronic conditions, as patients have lived longer, newer long-term risks have become evident, and there is growing concern that children with JSLE have an increased risk of cardiovascular disease (CVD) as they age.…”