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Predictors of arthritis in pediatric patients with lupus.

Sule SD, Moodalbail DG, Burnham J, Fivush B, Furth SL - Pediatr Rheumatol Online J (2015)

Bottom Line: Although typically non-erosive and non-deforming, children with SLE arthritis can have significant morbidity with decreased quality of life.Forty seven children and adolescents with SLE were followed in the cohort, 91 % female and 68 % Black.In cross-sectional analyses, presence of malar rash was associated with arthritis.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins University, Baltimore, MD, USA. ssule@jhmi.edu.

ABSTRACT

Background: Arthritis is one of the most common manifestations of systemic lupus erythematosus (SLE). Although typically non-erosive and non-deforming, children with SLE arthritis can have significant morbidity with decreased quality of life. Our goal was to identify potential clinical and laboratory predictors of arthritis in a cohort of pediatric patients with SLE.

Methods: We performed a cohort study of incident and prevalent patients with SLE aged ≤ 19 years. In cross sectional analysis, we compared demographic and clinical characteristics at initial clinic presentation between patients with arthritis noted at any time during follow-up and those without arthritis. We performed time to event analysis using Cox proportional hazard ratios to identify predictors of arthritis, clustering for repeated measures.

Results: Forty seven children and adolescents with SLE were followed in the cohort, 91 % female and 68 % Black. In cross-sectional analyses, presence of malar rash was associated with arthritis. In longitudinal analyses, controlling for gender and race, increased age (HR: 1.4, 95 % CI: 1.1-1.7), malar rash (HR: 2.1, 95 % CI: 1.1-3.6), and presence of RNP antibodies (HR: 1.9, 95 % CI: 1.1-3.4) were predictive of arthritis. When controlling for gender, race, and medication use, anemia (HR: 8.5, 95 % CI: 2.9-24.2) and thrombocytopenia (HR: 6.1, 95 % CI: 2.4-15.6) were associated with increased risk of arthritis.

Conclusions: We identified markers predictive of arthritis in a longitudinal cohort of children with SLE. The recognition of these markers may help clinicians identify patients at risk for arthritis before its onset thus improving quality of life in children with SLE.

No MeSH data available.


Related in: MedlinePlus

Timeline of Arthritis Development. Arthritis presented in all patients within two years of the diagnosis of SLE
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Fig1: Timeline of Arthritis Development. Arthritis presented in all patients within two years of the diagnosis of SLE

Mentions: In this cohort, 10/47 (21 %) had arthritis noted at multiple non-consecutive clinic visits for a total of 60 episodes of arthritis during longitudinal follow-up. 2/10 patients had arthritis at the initial diagnosis of SLE; no patients had only a single episode of arthritis. As show in Fig. 1, the majority of patients presented with arthritis within two years from time of SLE diagnosis. The most common joints involved included the hand (8/10), wrist (6/10), knee (4/10), and elbow (3/10). None of the patients had radiologic evaluation.Fig. 1


Predictors of arthritis in pediatric patients with lupus.

Sule SD, Moodalbail DG, Burnham J, Fivush B, Furth SL - Pediatr Rheumatol Online J (2015)

Timeline of Arthritis Development. Arthritis presented in all patients within two years of the diagnosis of SLE
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4499875&req=5

Fig1: Timeline of Arthritis Development. Arthritis presented in all patients within two years of the diagnosis of SLE
Mentions: In this cohort, 10/47 (21 %) had arthritis noted at multiple non-consecutive clinic visits for a total of 60 episodes of arthritis during longitudinal follow-up. 2/10 patients had arthritis at the initial diagnosis of SLE; no patients had only a single episode of arthritis. As show in Fig. 1, the majority of patients presented with arthritis within two years from time of SLE diagnosis. The most common joints involved included the hand (8/10), wrist (6/10), knee (4/10), and elbow (3/10). None of the patients had radiologic evaluation.Fig. 1

Bottom Line: Although typically non-erosive and non-deforming, children with SLE arthritis can have significant morbidity with decreased quality of life.Forty seven children and adolescents with SLE were followed in the cohort, 91 % female and 68 % Black.In cross-sectional analyses, presence of malar rash was associated with arthritis.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins University, Baltimore, MD, USA. ssule@jhmi.edu.

ABSTRACT

Background: Arthritis is one of the most common manifestations of systemic lupus erythematosus (SLE). Although typically non-erosive and non-deforming, children with SLE arthritis can have significant morbidity with decreased quality of life. Our goal was to identify potential clinical and laboratory predictors of arthritis in a cohort of pediatric patients with SLE.

Methods: We performed a cohort study of incident and prevalent patients with SLE aged ≤ 19 years. In cross sectional analysis, we compared demographic and clinical characteristics at initial clinic presentation between patients with arthritis noted at any time during follow-up and those without arthritis. We performed time to event analysis using Cox proportional hazard ratios to identify predictors of arthritis, clustering for repeated measures.

Results: Forty seven children and adolescents with SLE were followed in the cohort, 91 % female and 68 % Black. In cross-sectional analyses, presence of malar rash was associated with arthritis. In longitudinal analyses, controlling for gender and race, increased age (HR: 1.4, 95 % CI: 1.1-1.7), malar rash (HR: 2.1, 95 % CI: 1.1-3.6), and presence of RNP antibodies (HR: 1.9, 95 % CI: 1.1-3.4) were predictive of arthritis. When controlling for gender, race, and medication use, anemia (HR: 8.5, 95 % CI: 2.9-24.2) and thrombocytopenia (HR: 6.1, 95 % CI: 2.4-15.6) were associated with increased risk of arthritis.

Conclusions: We identified markers predictive of arthritis in a longitudinal cohort of children with SLE. The recognition of these markers may help clinicians identify patients at risk for arthritis before its onset thus improving quality of life in children with SLE.

No MeSH data available.


Related in: MedlinePlus