Abstract

Objective: To investigate differences in clinical signs and symptoms and in antinuclear antibodies (ANA) between patients with juvenile and adult onset systemic lupus erythematosus (SLE).

Methods: Clinical and serological data of 56 patients with juvenile onset SLE were compared with data of 194 adult onset SLE. ANA were determined by line immunoassay and by indirect immunofluorescence on Crithidia luciliae.

Results: Renal involvement, encephalopathy, and hemolytic anemia were seen significantly more often in juvenile onset SLE. Anti-dsDNA, anti-Ribosomal P, and anti-histone antibodies were found significantly more often in juvenile onset SLE. Anti-dsDNA antibodies were associated with renal involvement, whereas anti-Ribosomal P antibodies were inversely associated with renal involvement in juvenile onset SLE. In juvenile SLE patients with anti-dsDNA and without anti-Ribosomal P antibodies the odds ratio for glomerulonephritis was 9,000, whereas no patients with anti-Ribosomal P but lacking anti-dsDNA antibodies had renal involvement.

Conclusion: Patients with juvenile onset SLE more often have renal involvement and encephalopathy than patients with adult onset SLE. Anti-Ribosomal P, anti-dsDNA and anti-histone antibodies are more often found in patients with juvenile onset SLE. Anti-dsDNA antibodies were associated with renal involvement, whereas anti-Ribosomal P antibodies were inversely associated with renal involvement in patients with juvenile onset SLE.