Immunological and clinical differences between juvenile and adult onset of systemic lupus erythematosus

• Published in: Lupus 1999-01, Vol.8 (4), p.287-292
• Main Authors: Carreño, L, López-Longo, F J, Monteagudo, I, Rodríguez-Mahou, M, Bascones, M, González, C M, Saint-Cyr, C, Lapointe, N
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Age of Onset; Animals; Antibodies, Antinuclear - blood; Biomarkers; Cell Line; Child; Child, Preschool; Complement C3 - analysis; Complement C4 - analysis; Enzyme-Linked Immunosorbent Assay; Female; Hematuria - diagnosis; Humans; Immunoglobulin A - blood; Immunoglobulin G - blood; Immunoglobulin M - blood; Lupus Erythematosus, Discoid - diagnosis; Lupus Erythematosus, Discoid - immunology; Lupus Erythematosus, Systemic - diagnosis; Lupus Erythematosus, Systemic - immunology; Male; Rats
• ISSN: 0961-2033; 1477-0962
• DOI: 10.1191/096120399678847786

Introduction: Systemic lupus erythematosus (SLE) in children usually follows a more severe course than in adults, but sometimes in the previous studies reported there are many confounding factors Objective: To analyse the immunological and clinical characteristics of SLE juvenile onset and SLE adult onset. Methods: We studied 179 patients with SLE, 49 patients were aged 6 – 18 yrs at onset of disease. Anti-dsDNA antibodies were detected by radioimmunoassay and antibodies to extractable nuclear antigens (ENA): anti-nRNP, anti-Sm, anti-Ro/SS-A and anti-La/SS-B antibodies by ELISA, counterimmuno-electrophoresis and immunoblotting. Results: Juvenile-onset SLE shows a higher frequency of cutaneous vasculitis (44.8% vs 27.6%; P < 0.05), seizures (18.3% vs 7.6%; P < 0.05) nephropathy (67.3% vs 48.4%; P < 0.025), and discoid lupus erythematosus (26.5% vs 13.8%; P < 0.05). The incidence of articular manifestations is lower than in adults (85.7% vs 96.1%; P < 0.025). No significant differences were found between the two groups in relation with the prevalence of antinuclear antibodies. Conclusions: Juvenile-onset SLE has more frequent neurological and renal manifestations than adult-onset SLE, but immunological markers are similar in both groups. These features suggest the most severe clinical manifestations in the juvenile-onset SLE group are not related with the presence of studied antibodies by different methods.