Pancreatitis Subtypes Survey in 852 Childhood-Onset Systemic Lupus Erythematosus Patients

Pancreatitis Subtypes Survey in 852 Childhood-Onset Systemic Lupus Erythematosus Patients

Author Marques, Victor L. S. Google Scholar
Gormezano, Natali W. S. Google Scholar
Bonfa, Eloisa Google Scholar
Aikawa, Nadia E. Google Scholar
Terreri, Maria T. Autor UNIFESP Google Scholar
Pereira, Rosa M. Google Scholar
Magalhaes, Claudia S. Google Scholar
Guariento, Andressa Google Scholar
Appenzeller, Simone Google Scholar
Ferriani, Virginia P. Google Scholar
Barbosa, Cassia M. Google Scholar
Ramos, Valeria C. Google Scholar
Lotufo, Simone Google Scholar
Silva, Clovis A. Google Scholar
Abstract Objective:Pancreatitis is a rare and a life-threatening systemic lupus erythematosus (SLE) manifestation in childhood-onset SLE (cSLE). The objective of this study was to systematically classify pancreatitis in cSLE according to the International Study Group of Pediatric Pancreatitis and determine the overall prevalence, clinical features, laboratory, and first episode outcomes.Methods:A multicenter cohort study in 10 pediatric rheumatology centers, including 852 patients with cSLE.Results:Pancreatitis was diagnosed in 22 of 852 (2.6%) patients with cSLE. It was classified as acute pancreatitis in 20 (91%), acute recurrent pancreatitis in 2 (9%), and none of them had chronic pancreatitis. None of them had gallstones, traumatic pancreatitis, or reported alcohol/tobacco use. The comparison of patients with pancreatitis (first episode) and without this complication revealed a shorter disease duration (1 [0-10] vs 4 [0-23] years, P<0.0001) and higher median of Systemic Lupus Erythematosus Disease Activity Index 2000 (21 [0-41] vs 2 [0-45], P<0.0001). The frequencies of fever (P<0.0001), weight loss (P<0.0001), serositis (P<0.0001), nephritis (P<0.0001), arterial hypertension (P<0.0001), acute renal failure (P<0.0001), macrophage activation syndrome (P<0.0001), and death (P=0.001) were also higher in patients with pancreatitis. The frequencies of intravenous methylprednisolone use (P<0.0001) and the median of prednisone dose (55 [15-60] vs 11 [1-90] mg/day, P<0.0001) were significantly higher in patients with pancreatitis. Of note, the 2 patients with acute recurrent pancreatitis had 2 episodes, with pain-free interval of 1 and 4 years.Conclusions:This was the first study characterizing pancreatitis using the International Study Group of Pediatric Pancreatitis standardized definitions in patients with cSLE showing that the predominant form is acute pancreatitis seen in association with glucocorticoid treatment and active severe disease.
Keywords childhood-onset systemic lupus erythematosus
glucocorticoid
pancreatitis
Systemic Lupus Erythematosus Disease Activity Index
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Sponsor Conselho Nacional de Desenvolvimento Cientifico e Tecnologico
Federico Foundation
Nucleo de Apoio a Pesquisa "Saude da Crianca e do Adolescente" da USP (NAP-CriAd)
Grant number CNPq: 2009/51897-5
CNPq: 301805/2013-0
CNPq: 302724/2011-7
Date 2016
Published in Journal Of Pediatric Gastroenterology And Nutrition. Philadelphia, v. 62, n. 2, p. 328-334, 2016.
ISSN 0277-2116 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 328-334
Origin https://doi.org/10.1097/MPG.0000000000000990
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000369292300011
URI https://repositorio.unifesp.br/handle/11600/58494

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