Juvenile and adult onset systemic lupus erythematosus outcome in Egyptian patients

Abstract

The aim was to study the outcome characteristics of systemic lupus erythematosus (SLE) in Egyptians according to the age at disease onset and gender. We studied 239 SLE patients (185 adult and 54 Juvenile onset) with a female to male ratio of 9.39–1 and a mean age of 28.23 ± 8.91 years and disease duration of 5.45 ± 4.25 years. Full history taking, thorough clinical examination, laboratory and relevant radiological investigations were performed. Disease activity was assessed using SLEDAI and damage by SLICC. Renal biopsies were done in those with renal involvement. The clinical manifestations, disease activity and damage and laboratory investigations of the SLE patients varied according to the age at disease onset and gender. The prevalence of damage was obviously increased in juvenile patients and higher in males. Growth failure, delayed puberty and fibromyalgia were present more in Juvenile-onset patients. Adult onset SLE patients had a significantly higher secondary Sjögren syndrome especially in females. In the present study, there was a 2.5% mortality and the commonly involved kidneys were an important cause of death. Measuring organ damage in SLE is important with special concern to juvenile-onset patients to allow for designing new treatments that improve control of disease activity and minimize the development of irreversible damage. The kidney appeared to be commonly involved, especially in males, indicating the importance of regular screening for early and appropriate management.