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

dc.contributor.authorSakamoto, Ana Paula [UNIFESP]
dc.contributor.authorSilva, Clovis Artur
dc.contributor.authorLeme Ferriani, Mariana Paes
dc.contributor.authorRodrigues Pereira, Rosa Maria
dc.contributor.authorBonfa, Eloisa
dc.contributor.authorSaad-Magalhaes, Claudia
dc.contributor.authorOkuda, Eunice
dc.contributor.authorAppenzeller, Simone
dc.contributor.authorGomes, Francisco Hugo
dc.contributor.authorGarcia Cunha, Ana Luiza [UNIFESP]
dc.contributor.authorTomich Salume, Mirna Henriques [UNIFESP]
dc.contributor.authorPiotto, Daniela Gerent Petry [UNIFESP]
dc.contributor.authorTerreri, Maria Teresa Ramos Ascensão [UNIFESP]
dc.description.abstractChronic 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.en
dc.description.affiliationUniv Fed Sao Paulo, Pediat Rheumatol Unit, Rua Borges Lagoa 802, BR-04083001 Sao Paulo, SP, Brazil
dc.description.affiliationUniv Sao Paulo, Pediat Rheumatol Unit, Fac Med, Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Div Rheumatol, Fac Med, Sao Paulo, Brazil
dc.description.affiliationSao Paulo State Univ UNESP, Div Pediat Rheumatol, Fac Med Botucatu, Sao Paulo, Brazil
dc.description.affiliationIrmandade Santa Casa de Misericordia Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil
dc.description.affiliationState Univ Campinas UNICAMP, Pediat Rheumatol Unit, Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Ribeirao Preto Med Sch, Pediat Rheumatol Unit, Sao Paulo, Brazil
dc.description.affiliationUnifespPediatric Rheumatology Unit, Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipFederico Foundation
dc.description.sponsorshipNúcleo de Apoio à Pesquisa "Saúde da Criança e do Adolescente" da Universidade de São Paulo (NAP-CriAd)
dc.description.sponsorshipIDCNPq: 303422/2015-7
dc.description.sponsorshipIDCNPq: 301805/2013-0
dc.description.sponsorshipIDCNPq: 305068/2014-8
dc.description.sponsorshipIDCNPq: 301479/2015
dc.description.sponsorshipIDCNPq: 303752/2015-7
dc.identifier.citationRheumatology International. Heidelberg, v. 36, n. 12, p. 1641-1648, 2016.
dc.publisherSpringer Heidelberg
dc.relation.ispartofRheumatology International
dc.rightsAcesso restrito
dc.subjectChronic arthritisen
dc.subjectJaccoud's arthropathyen
dc.subjectChildhood-onset systemic lupus erythematosusen
dc.subjectSystemic lupus erythematosusen
dc.titleCharacterization of chronic arthritis in a multicenter study of 852 childhood-onset systemic lupus erythematosus patientsen