Characterization of chronic arthritis in a multicenter study of 852 childhood-onset systemic lupus erythematosus patients

Characterization of chronic arthritis in a multicenter study of 852 childhood-onset systemic lupus erythematosus patients

Author Sakamoto, Ana Paula Autor UNIFESP Google Scholar
Silva, Clovis Artur Google Scholar
Leme Ferriani, Mariana Paes Google Scholar
Rodrigues Pereira, Rosa Maria Google Scholar
Bonfa, Eloisa Google Scholar
Saad-Magalhaes, Claudia Google Scholar
Okuda, Eunice Google Scholar
Appenzeller, Simone Google Scholar
Gomes, Francisco Hugo Google Scholar
Garcia Cunha, Ana Luiza Autor UNIFESP Google Scholar
Tomich Salume, Mirna Henriques Autor UNIFESP Google Scholar
Piotto, Daniela Gerent Petry Autor UNIFESP Google Scholar
Terreri, Maria Teresa Ramos Ascensão Autor UNIFESP Google Scholar
Abstract Chronic arthritis (CA) is an unusual condition in childhood-onset systemic lupus erythematosus (cSLE) and data in children is very limited. The aim of the study is to assess CA in a large population of cSLE patients, in a multicenter cross-sectional study including 852 cSLE patients followed in ten Pediatric Rheumatology referral services in state of So Paulo, Brazil. CA was observed in 32/852 (3.7 %) cSLE patients mostly in hands and ankles. Chronic monoarthritis was diagnosed in four cSLE patients, oligoarthritis in nine and polyarthritis in 19. In the latter group, six had rhupus syndrome. Two oligoarticular patients had Jaccoud's arthropathy. CA was an isolated manifestation observed at disease onset in 13/32 (41 %) cSLE patients, and juvenile idiopathic arthritis (JIA) was the first diagnosis in 18/32 (56 %). The comparison of last visit of patients with CA and without this manifestation revealed higher frequency of splenomegaly (28 vs. 11 %, p = 0.002). The median of SLICC/ACR-DI score [1(0-9) vs. 0(0-7), p = 0.003] was significantly higher in CA patients compared to patients without this manifestation, likewise the frequency of musculoskeletal damage (31 vs. 9 % p = 0.001). Frequencies of treatment with nonsteroidal anti-inflammatory drugs (75 vs. 26 %, p < 0.0001), hydroxychloroquine sulfate (87 vs. 59 %, p = 0.001) and methotrexate (47 vs. 22 %, p = 0.001) were significantly higher in CA patients. This large multicenter study allowed us to characterize CA as a rare and early manifestation of cSLE, frequently mimicking JIA at disease onset. It is predominantly polyarticular, involving more often hands and ankles and it is associated with significant musculoskeletal accrual damage.
Keywords Childhood
Chronic arthritis
Rhupus
Jaccoud's arthropathy
Childhood-onset systemic lupus erythematosus
Systemic lupus erythematosus
xmlui.dri2xhtml.METS-1.0.item-coverage Heidelberg
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Federico Foundation
Núcleo de Apoio à Pesquisa "Saúde da Criança e do Adolescente" da Universidade de São Paulo (NAP-CriAd)
Grant number CNPq: 303422/2015-7
CNPq: 301805/2013-0
CNPq: 305068/2014-8
CNPq: 301479/2015
CNPq: 303752/2015-7
Date 2016
Published in Rheumatology International. Heidelberg, v. 36, n. 12, p. 1641-1648, 2016.
ISSN 0172-8172 (Sherpa/Romeo, impact factor)
Publisher Springer Heidelberg
Extent 1641-1648
Origin http://dx.doi.org/10.1007/s00296-016-3564-6
Access rights Closed access
Type Article
Web of Science ID WOS:000387660100003
URI https://repositorio.unifesp.br/handle/11600/56686

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