Disease presentation of 1312 childhood-onset systemic lupus erythematosus: influence of ethnicity

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFIOROT, Fernanda J.
dc.contributor.authorISLABAO, Aline G.
dc.contributor.authorPEREIRA, Rosa M.
dc.contributor.authorTERRERI, Maria T.
dc.contributor.authorSAAD-MAGALHAES, Claudia
dc.contributor.authorV, Glaucia Novak
dc.contributor.authorMOLINARI, Beatriz C.
dc.contributor.authorSAKAMOTO, Ana P.
dc.contributor.authorAIKAWA, Nadia E.
dc.contributor.authorCAMPOS, Lucia M.
dc.contributor.authorPERACCHI, Octavio A.
dc.contributor.authorAPPENZELLER, Simone
dc.contributor.authorFERRIANI, Virginia P.
dc.contributor.authorSILVA, Marco F.
dc.contributor.authorFONSECA, Adriana R.
dc.contributor.authorSZTAJNBOK, Flavio R.
dc.contributor.authorPAIM, Luciana B.
dc.contributor.authorFRAGA, Melissa M.
dc.contributor.authorOKUDA, Eunice M.
dc.contributor.authorBICA, Blanca E.
dc.contributor.authorSENA, Evaldo G.
dc.contributor.authorMORAES, Ana J.
dc.contributor.authorROLIM, Ana M.
dc.contributor.authorSPELLING, Paulo F.
dc.contributor.authorSCHEIBEL, Iloite M.
dc.contributor.authorCAVALCANTI, Andre S.
dc.contributor.authorMATOS, Erica N.
dc.contributor.authorROBAZZI, Teresa C.
dc.contributor.authorGUIMARAES, Luciano J.
dc.contributor.authorSANTOS, Flavia P.
dc.contributor.authorRAMOS, Valeria C.
dc.contributor.authorCARNEIRO-SAMPAIO, Magda
dc.contributor.authorBONFA, Eloisa
dc.contributor.authorSILVA, Clovis A.
dc.contributor.groupauthorBrazilian Childhood-onset Syst Lup
dc.date.accessioned2020-01-21T14:53:58Z
dc.date.available2020-01-21T14:53:58Z
dc.date.issued2019
dc.description.abstractObjective To evaluate the influence of ethnicity in presentation of childhood-onset systemic lupus erythematosus (cSLE) patients. Methods This multicenter study included cSLE patients (American College of Rheumatology criteria) followed in 27 Pediatric Rheumatology services of Brazil. Ethnicities were classified in four groups according to the parents' and all four grandparents' self-reported ethnicity. The statistical analysis was performed using the Bonferroni's correction (p < 0.0027). Results According to ethnic groups, 1537 cSLE patients were classified in Caucasian (n = 786), African-Latin American (n = 526), Asian (n = 8), and others/unknown (n = 217). Comparisons between 1312 African-Latin American and Caucasian revealed similar median age at cSLE diagnosis [12.2(2.6-18) vs. 12.1(0.3-18) years, p = 0.234], time interval to diagnosis [0.25(0-12) vs. 0.3(0-10) years, p = 0.034], and SLEDAI-2K score [14(0-55) vs. 14(0-63), p = 0.781] in both groups. The mean number of diagnostic criteria according to SLICC (6.47 +/- 1.911 vs. 5.81 +/- 1.631, p < 0.0001) and frequencies of maculopapular lupus rash (8% vs. 3%, p < 0.0001), palate oral ulcers (17% vs. 11%, p = 0.001), tongue oral ulcers (4% vs. 1%, p = 0.001), and nonscarring alopecia (29% vs. 16%, p < 0.0001) were significantly higher in African-Latin American, whereas malar rash (45% vs. 58%, p < 0.0001) was more frequent in Caucasian. The presence of anti-phospholipid antibody (23% vs. 12%, p < 0.0001), low complement levels (58% vs. 41%, p < 0.0001), and isolated direct Coombs test (10% vs. 5%, p = 0.001) was also significantly higher in the former group. Conclusions Our study demonstrated that disease presentation severity of African-Latin American cSLE patients is comparable with Caucasian. Mucocutaneous manifestations and autoantibodies profile were the only distinctive features of the former group. The unique mixed background of Brazilian patients probably minimized race diversity spectrum of these patients.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao PauloFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [FAPESP 2015/03756-4]
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e TecnologicoNational Council for Scientific and Technological Development (CNPq) [CNPq 303752/2015-7, 301805/2013-0, 305068/2014-8, 303422/2015-7]
dc.description.sponsorshipFederico Foundation
dc.description.sponsorshipNucleo de Apoio a Pesquisa ""Saude da Crianca e do Adolescente"" da USP (NAP-CriAd)
dc.identifier.citationCLINICAL RHEUMATOLOGY, v.38, n.10, p.2857-2863, 2019
dc.identifier.doi10.1007/s10067-019-04631-0
dc.identifier.eissn1434-9949
dc.identifier.issn0770-3198
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/34297
dc.language.isoeng
dc.publisherSPRINGER LONDON LTDeng
dc.relation.ispartofClinical Rheumatology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGER LONDON LTDeng
dc.subjectAnti-phospholipid antibodyeng
dc.subjectChildhood-onset systemic lupus erythematosuseng
dc.subjectEthnicityeng
dc.subjectRaceeng
dc.subject.otherclassificationeng
dc.subject.othermanifestationseng
dc.subject.othermulticentereng
dc.subject.otherfeatureseng
dc.subject.othercriteriaeng
dc.subject.wosRheumatologyeng
dc.titleDisease presentation of 1312 childhood-onset systemic lupus erythematosus: influence of ethnicityeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalISLABAO, Aline G.:Hosp Jose Alencar, Pediat Rheumatol Unit, Brasilia, DF, Brazil
hcfmusp.author.externalTERRERI, Maria T.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.author.externalSAAD-MAGALHAES, Claudia:Sao Paulo State Univ UNESP, Pediat Rheumatol Div, Botucatu, SP, Brazil
hcfmusp.author.externalSAKAMOTO, Ana P.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.author.externalPERACCHI, Octavio A.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.author.externalAPPENZELLER, Simone:Univ Estadual Campinas, Pediat Rheumatol Unit, UNICAMP, Campinas, SP, Brazil
hcfmusp.author.externalFERRIANI, Virginia P.:Univ Sao Paulo, Ribeirao Preto Med Sch, Pediat Rheumatol Unit, Ribeirao Preto, Brazil
hcfmusp.author.externalSILVA, Marco F.:Hosp Geral Fortaleza, Pediat Rheumatol Unit, Fortaleza, Ceara, Brazil
hcfmusp.author.externalFONSECA, Adriana R.:Rio de Janeiro Fed Univ IPPMG UFRJ, Pediat Rheumatol Unit, Rio De Janeiro, Brazil
hcfmusp.author.externalSZTAJNBOK, Flavio R.:Pedro Ernesto Univ Hosp, Pediat Rheumatol Unit, Rio De Janeiro, Brazil
hcfmusp.author.externalPAIM, Luciana B.:Albert Sabin Childrens Hosp, Pediat Rheumatol Unit, Fortaleza, Ceara, Brazil
hcfmusp.author.externalFRAGA, Melissa M.:Hosp Darcy Vargas, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.author.externalOKUDA, Eunice M.:Irmandade Santa Casa de Misericordia Sao Paulo, Sao Paulo, Brazil
hcfmusp.author.externalBICA, Blanca E.:Univ Fed Rio de Janeiro, Rheumatol Div, Hosp Univ Clementino Fraga Filho, Rio De Janeiro, Brazil
hcfmusp.author.externalSENA, Evaldo G.:Lauro Vanderley Univ Hosp, Pediat Rheumatol Unit, Joao Pessoa, Paraiba, Brazil
hcfmusp.author.externalMORAES, Ana J.:Fed Univ Para, Pediat Rheumatol Unit, Belem, Para, Brazil
hcfmusp.author.externalROLIM, Ana M.:Obras Sociais Irma Dulce, Pediat Rheumatol Unit, Salvador, BA, Brazil
hcfmusp.author.externalSPELLING, Paulo F.:Hosp Evangel Curitiba, Pediat Rheumatol Unit, Curitiba, Parana, Brazil
hcfmusp.author.externalSCHEIBEL, Iloite M.:Hosp Crianca Conceicao, Pediat Rheumatol Unit, Porto Alegre, RS, Brazil
hcfmusp.author.externalCAVALCANTI, Andre S.:Univ Fed Pernambuco, Pediat Rheumatol Unit, Recife, PE, Brazil
hcfmusp.author.externalMATOS, Erica N.:Univ Fed Mato Grosso do Sul, Pediat Rheumatol Unit, Campo Grande, Brazil
hcfmusp.author.externalROBAZZI, Teresa C.:Univ Fed Bahia, Pediat Rheumatol Unit, Salvador, BA, Brazil
hcfmusp.author.externalGUIMARAES, Luciano J.:Univ Brasilia, Pediat Rheumatol Unit, Brasilia, DF, Brazil
hcfmusp.author.externalSANTOS, Flavia P.:Univ Fed Minas Gerais, Pediat Rheumatol Unit, Belo Horizonte, MG, Brazil
hcfmusp.author.externalRAMOS, Valeria C.:Pontificia Catholic Univ Sorocaba, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.citation.scopus18
hcfmusp.contributor.author-fmusphcFERNANDA JUSAN FIOROT
hcfmusp.contributor.author-fmusphcROSA MARIA RODRIGUES PEREIRA
hcfmusp.contributor.author-fmusphcGLAUCIA VANESSA NOVAK
hcfmusp.contributor.author-fmusphcBEATRIZ CARMONA MOLINARI
hcfmusp.contributor.author-fmusphcNADIA EMI AIKAWA
hcfmusp.contributor.author-fmusphcLUCIA MARIA MATTEI DE ARRUDA CAMPOS
hcfmusp.contributor.author-fmusphcMAGDA MARIA SALES CARNEIRO SAMPAIO
hcfmusp.contributor.author-fmusphcELOISA SILVA DUTRA DE OLIVEIRA BONFA
hcfmusp.contributor.author-fmusphcCLOVIS ARTUR ALMEIDA DA SILVA
hcfmusp.description.beginpage2857
hcfmusp.description.endpage2863
hcfmusp.description.issue10
hcfmusp.description.volume38
hcfmusp.origemWOS
hcfmusp.origem.pubmed31209708
hcfmusp.origem.scopus2-s2.0-85067670824
hcfmusp.origem.wosWOS:000493610600024
hcfmusp.publisher.cityLONDONeng
hcfmusp.publisher.countryENGLANDeng
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