Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/329569
Type: Artigo
Title: Characterization Of Chronic Arthritis In A Multicenter Study Of 852 Childhood-onset Systemic Lupus Erythematosus Patients
Author: Sakamoto
Ana Paula; Silva
Clovis Artur; Leme Ferriani
Mariana Paes; Rodrigues Pereira
Rosa Maria; Bonfa
Eloisa; Saad-Magalhaes
Claudia; Okuda
Eunice; Appenzeller
Simone; Gomes
Francisco Hugo; Garcia Cunha
Ana Luiza; Tomich Salume
Mirna Henriques; Piotto
Daniela Petry; Terreri
Maria Teresa
Abstract: Chronic 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.
Subject: Childhood
Chronic Arthritis
Rhupus
Jaccoud's Arthropathy
Childhood-onset Systemic Lupus Erythematosus
Systemic Lupus Erythematosus
Editor: Springer Heidelberg
Heidelberg
Rights: fechado
Identifier DOI: 10.1007/s00296-016-3564-6
Address: https://link-springer-com.ez88.periodicos.capes.gov.br/article/10.1007%2Fs00296-016-3564-6
Date Issue: 2016
Appears in Collections:Unicamp - Artigos e Outros Documentos

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