Uveitis in childhood-onset systemic lupus erythematosus patients: a multicenter survey
Carregando...
Data
2017-03-01
Autores
Kahwage, Paola Pinheiro
Ferriani, Mariana Paes Leme
Furtado, João M.
de Carvalho, Luciana Martins
Pileggi, Gecilmara Salviato
Gomes, Francisco Hugo Rodrigues
Terreri, Maria Teresa
Magalhães, Claudia Saad [UNESP]
Pereira, Rosa Maria Rodrigues
Sacchetti, Silvana Brasilia
Título da Revista
ISSN da Revista
Título de Volume
Editor
Resumo
The aim of this study is to assess uveitis prevalence in a large cohort of childhood-onset systemic lupus erythematosus (cSLE) patients. A retrospective multicenter cohort study including 852 cSLE patients was performed in ten pediatric rheumatology centers (Brazilian cSLE group). An investigator meeting was held and all participants received database training. Uveitis was diagnosed through clinical assessment by the uveitis expert ophthalmologist of each center. Patients with and without uveitis were assessed for lupus clinical/laboratory features and treatments. Uveitis was observed in 7/852 cSLE patients (0.8%). Two of them had ocular complications: cataract and irreversible blindness in one patient and retinal ischemia with subsequent neovascularization and unilateral blindness in another. Uveitis was identified within the first 6 months of cSLE diagnosis in 6/7 patients (86%). Comparison of a subgroup of cSLE patients with (n = 7) and without uveitis (n = 73) and similar length of disease duration showed that patients with uveitis had increased SLEDAI-2K score (19 vs. 6; p < 0.01). In addition, fever (71 vs. 12%; p < 0.01), lymphadenopathy (29 vs. 1.4%; p = 0.02), arthritis (43 vs. 7%; p = 0.02), and use of intravenous methylprednisolone (71 vs. 22%; p = 0.01) were higher in cSLE patients with uveitis, as compared to those without this manifestation, respectively. Presence of fever was significantly associated with uveitis, independently of SLEDAI scores or use of intravenous methylprednisolone pulses, as shown by adjusted regression analysis (adjusted prevalence ratio 35.7, 95% CI 2.4–519.6; p < 0.01). Uveitis was a rare and initial manifestation of active cSLE patients. Early recognition is essential due to the possibility of irreversible blindness.
Descrição
Palavras-chave
Childhood-onset systemic lupus erythematosus, Cohort study, SLEDAI, Uveitis
Como citar
Clinical Rheumatology, v. 36, n. 3, p. 547-553, 2017.