Coexistence of allergic diseases in pediatric systemic lupus erythematosus patients: prevalence, clinical manifestation, severity and its association with disease activity

Abstract

Background The prevalence of both allergic and autoimmune diseases is increasing, suggesting a potential association between these two disorders. Systemic lupus erythematosus (SLE) is a prototypical systemic autoimmune disease associated with multisystem organ involvement. This study aimed to investigate the prevalence, clinical manifestations and severity of allergic diseases in pediatric SLE patients and describe the association between severity of allergic diseases and SLE disease activity. Methods Pediatric SLE patients aged ≤ 18 years attending Khon Kaen University hospital, Thailand were enrolled during 2020–2022. Allergic diseases were screened using the International Study of Asthma and Allergies in Childhood questionnaire. SLE patients with a positive allergic disease screen were evaluated by a pediatric allergist for diagnostic confirmation using clinical criteria/testing. Correlation between SLE disease activity and the severity of allergic diseases was investigated using Spearman rank-order correlation coefficient. Results Out of 118 patients (median age 13.83 [11.71–15.90], 91.52% female),16 patients (13.56%) were confirmed to have one or more allergic diseases; fourteen with allergic rhinitis, four with asthma, and two with atopic dermatitis. Our study newly confirmed four patients with allergic rhinitis, one patient with atopic dermatitis and one patient with asthma. Two patients had severe-persistent allergic rhinitis and one newly diagnosed patient had uncontrolled severe asthma. No statistically significant correlations between the severity of allergic diseases and SLE disease activity were identified Conclusions The overall prevalence of allergic disease among pediatric SLE patients is 13.56% and is not less frequent than in the general population. Severe allergic diseases and SLE can coexist and allergies may be undiagnosed. Therefore, pediatric SLE patients should be assessed for coexisting allergic diseases. No correlations between the severity of allergic diseases and SLE disease activity were found.