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AB0608 Greater Organ Involvement and Disease Activity in Childhood-Onset than Adult-Onset With SLE (DATA from Reuma.Pt/Les)
  1. S.I. Sousa1,
  2. M.J. Gonçalves2,
  3. L. Inês3,
  4. G. Eugénio3,
  5. D. Jesus3,
  6. S. Fernandes4,
  7. G. Terroso5,
  8. V. Romão2,
  9. M. Cerqueira6,
  10. A. Raposo6,
  11. M. Couto7,
  12. P. Nero8,
  13. G. Sequeira9,
  14. T. Novoa10,
  15. J. Melo Gomes4,
  16. J. Canas da Silva1,
  17. L. Costa5,
  18. C. Macieira2,
  19. C. Silva4,
  20. J. Pereira da Silva3,
  21. H. Canhão2,
  22. M.J. Santos1
  1. 1Rheumatology, Hospital Garcia de Orta, Almada
  2. 2Rheumatology, Hospital Santa Maria, Lisbon
  3. 3Rheumatology, Hospitais Universidade Coimbra, Coimbra
  4. 4Rheumatology, Instituto Português Reumatologia, Lisbon
  5. 5Rheumatology, Centro Hospitalar São João, Porto
  6. 6Rheumatology, Hospital Conde Bertiandos, Ponte de Lima
  7. 7Rheumatology, Hospital Viseu, Viseu
  8. 8Rheumatology, Hospital Egas Moniz, Lisbon
  9. 9Rheumatology, Centro Hospitalar Faro, Faro
  10. 10Rheumatology, Hospital Divino Espirito Santo, Ponta Delgada, Portugal

Abstract

Background Systemic lupus erythematosus (SLE) is a multi-organ immune-mediated disease that affects predominantly women at reproductive age but may present itself at any age. Age at disease onset has a strong modulating effect on clinical presentation and course of disease. Although young patients may have a more aggressive disease, controversies persist regarding the impact of age at disease onset on SLE outcome.

Objectives Characterize childhood-onset, adult-onset and late-onset SLE and assess whether disease outcome differs in these three patient groups.

Methods Patients with childhood-onset (diagnosis ≤18 years) SLE fulfilling ACR 1997 criteria were identified in the Portuguese registry Reuma.pt/SLE and compared with adult-onset (≥19y and ≤49 years) and late-onset (≥50 years) SLE patients paired for disease duration.

Results Two hundred and sixty seven SLE patients with mean disease duration of 11.9±9.3 years were analyzed (Table 1). The number of fulfilled ACR criteria was significantly higher in childhood-onset SLE. A greater proportion of women, higher prevalence of arthritis and anti-SSA antibodies were noted in the adult-onset group. Hypertension, diabetes and thyroid disease were significantly more prevalent in late-onset SLE. Disease activity at last visit evaluated using the SLEDAI-2K was significantly higher in childhood-onset group than in the late-onset counterparts. SLICC/ACR damage index was numerically higher in late-onset SLE and significantly more patients in this group had irreversible damage. Cyclophosphamide and mycophenolate mophetil were used more frequently in childhood-onset SLE patients.

Table 1.

Demographic and clinical characteristics of childhood-onset, adult-onset and late-onset SLE

Conclusions The skin, kidney and neurological involvement are most common in childhood-onset, as well as the use of immunosuppressants, supporting the concept of a more severe disease. In contrast, patients with late-onset SLE have more comorbidities and irreversible damage. The age of SLE onset has a significant impact not only on the clinical characteristics and disease activity, but is also important for disease outcome.

Disclosure of Interest None declared

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