Juvenile systemic lupus erythematosus: onset patterns and short-term outcome in Egyptian children, a single-center experience

Abdel-Hafez, Maher; Abdelnabi, Hend Hassan

doi:10.1177/0961203315598016

Cited by 19 publications

(17 citation statements)

References 31 publications

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“…As regard to sociodemographic data of patients, female-to-male ratio was 7:1, which refers to significance of endocrinal factors in the clinical presentation of SLE. On comparison to other Arab researches in pediatric age, it was similar to the study reported by Abdel-Hafez and Abdel-Nabi, 2015[10] (7:1), lower than the study of Bakr, 2005[11] (12:1) and higher than the study of Salah et al , 2009[12] (2.7:1) and Ali et al , 1989,[13] which was on Indian kids (4:1), Uziel et al , 2007,[14] which was on Israeli children, (5:1), and Dunget et al , 2012[15] inVietnam (4:1). Difference in gender distribution might be due to different numbers of patients, due to differences in ethnicity or due to genetic factors.…”

Section: Discussionsupporting

confidence: 90%

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Urinary neutrophil gelatinase-associated lipocalin and urinary soluble CXCL16 as biomarkers of activity in pediatric lupus nephritis

El-Gamasy

El-Naghy

2018

Indian J Nephrol

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One of the challenges of treating patients with lupus nephritis (LN) is to assess disease activity. The aim of this study was to measure the urinary neutrophil gelatinase-associated lipocalin (uNGAL) and urinary soluble chemokine (C-X-C motif) ligand 16 (CXCL16) levels in children and adolescents with systemic lupus erythematosus (SLE) and investigate whether they are elevated in active LN. This study was conducted on 80 patients diagnosed as SLE by the Systemic Lupus International Collaborating Clinics criteria and 60 apparently healthy individuals as controls. Global and renal disease activities were evaluated by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and renal SLEDAI, respectively. uNGAL and urinary CXCL16 were measured for all participants by ELISA. Renal biopsy was done for all cases at initial diagnosis and was graded using ISN/RPS classification. uNGAL and CXCL16 were higher in patients than in the controls (8.9 ± 3.56 ng/dl and 1067 ± 367 ug/L vs. 2.26 ± 1.95 ng/dl and 471 ± 106 ug/L, respectively). uNGAL had higher sensitivity and specificity than urinary CXCL16 as predictor of LN (95% and 90% vs. 85% and 80%, respectively). There was significant positive correlations between uNGAL levels, 24-h urinary proteins (r = 0.732, P = 0.001), and SLEDAI (r = 0.359, P = 0.001). There was also significant positive correlations between urinary CXCL16 levels, 24-h urinary proteins (r = 0.47, P = 0.001), and SLEDAI (r = 0.17, P = 0.001). uNGAL and CXCL16 were reliable indicators of the activity of LN.

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Section: Discussionsupporting

confidence: 90%

“…[16] Global and rSLEDAI score have been used in our study as the predictors of disease activity. [7] The mean global SLEDAI score was 28.6 ± 21.46 and was similar to that of Abdel-Hafez and Abdel-Nabi, 2015[10] (29.95 ± 2.06), and study by Dunget et al ,[15] 2012 (23.8 ± 11.6).…”

Section: Discussionsupporting

confidence: 78%

Urinary neutrophil gelatinase-associated lipocalin and urinary soluble CXCL16 as biomarkers of activity in pediatric lupus nephritis

El-Gamasy

El-Naghy

2018

Indian J Nephrol

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“…It is worth noting that female predominance was less prominent in the juvenile-onset group with a male:female ratio of 7:1 as opposed to 9:1 in the adult group, and this finding is similar to several other Egyptian 38–41 and international reports. 33–36…”

Section: Discussionsupporting

confidence: 89%

Characteristics of systemic lupus erythematosus in a sample of the Egyptian population: a retrospective cohort of 1109 patients from a single center

Hadidi

Medhat

Baki

et al. 2018

Lupus

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Introduction Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can vary among different ethnic and racial groups. Objective The objective of this paper is to study the prevalence of various manifestations of SLE in a sample of the Egyptian population. Patients and methods Information in this study was derived from the medical records of SLE patients who sought medical advice at a private clinic in Cairo from January 1980 to June 2016. Results This study included 1109 SLE patients, of whom 114 (10.3%) were males and 995 were females (89.7%). Mean age of onset was 25.89 ± 10.81 years, while the median of disease duration from the onset of the disease till the last recorded visit was 26 months. The most common cumulative manifestations were arthritis (76.7%), malar rash (48.5%), leukopenia (45.7%), and photosensitivity (45.6%). A total of 33.1% of the patients had nephritis, and neuropsychiatric lupus was present in 6.4% of the patients. Secondary antiphospholipid syndrome was present in 11.5% of the patients. Antinuclear antibody and anti-double-stranded deoxyribonucleic acid were present in 1060/1094 (96.9%) and 842/1062 (79.3%) of the patients, respectively. Antiphospholipid antibodies were present in 266/636 (41.8%) of the patients, anti-Smith in 54/240 (22.5%), anti-SSA/Ro in 61/229 (20.4%), and anti-SSB/La in 32/277 (11.6%) of the patients. Male patients had a statistically higher prevalence of nephritis ( p = 0.01), whereas arthritis and alopecia were statistically higher in females ( p = 0.012 and p = 0.006, respectively). Patients with juvenile onset had a statistically higher prevalence of nephritis and seizures ( p < 0.001 and p = 0.012, respectively). Conclusions Arthritis and malar rash represented the most common clinical manifestations. Male and juvenile-onset patients had a predilection toward a more severe disease. These results are in agreement with many studies conducted in the Middle East and worldwide. On the other hand, major organ involvement was exceptionally low, which is contradictory to several reports from the Middle East and across the globe.

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“…5–7,25 Although to a lesser extent than in adult studies, the proportion of females in jSLE studies is also fairly high, ranging from 80% to 90.9%. 7,19–24,26–29 We have seen somewhat a lower frequency of females (77.2%) in our study compared to previous jSLE studies. Since estrogens have been shown to play a triggering role in the etiology of SLE, 30 dissimilarity of the pubertal state may be the reason for this female:male ratio discrepancy across different studies.…”

Section: Discussioncontrasting

confidence: 77%

“…The most frequently encountered manifestations in our jSLE cohort were mucocutaneous manifestations, followed by constitutional, hematological and musculoskeletal manifestations, similar to the previous studies. 19–24…”

Section: Discussionmentioning

confidence: 99%

Juvenile systemic lupus erythematosus in Turkey: demographic, clinical and laboratory features with disease activity and outcome

Şahin

Adroviç

Barut

et al. 2017

Lupus

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Objectives This paper aims to assess in a retrospective fashion the clinical and laboratory features, severity and outcome of juvenile systemic lupus erythematosus (jSLE) from a referral center in Turkey. Methods We have included all jSLE patients ( n = 92) diagnosed according to the revised American College of Rheumatology 1997 criteria between January 2004 and January 2017. Results The most prevalent clinical feature in our cohort was mucocutaneous manifestations (97.8%), followed by constitutional (81.5%), hematological (59.8%) and musculoskeletal manifestations (56.5%). Renal involvement was observed in 38% ( n = 35) of the patients, whereas biopsy-proven lupus nephritis was detected in 29.3% ( n = 27) of the cohort. Neurologic involvement was seen in 15 (16.3%) individuals. Among the patients positive for anticardiolipin IgM and/or IgG ( n = 11, 12%), only three developed antiphospholipid antibody syndrome. The mean SLEDAI-2K scores at disease onset (10.5 ± 4.8) showed a substantial decrease at last visit (4.3 ± 4.6). One-quarter of the patients (26.1%, n = 24) had damage according to the PedSDI criteria with a mean score of 0.45 ± 1.0 (range 0-7). When the PedSDI damage items were evaluated individually, growth failure was the most frequent damage criterion ( n = 6), followed by seizure ( n = 5). Two patients died during the designated study period of end-stage renal disease. The five-year and 10-year survival rate of our cohort was 100% and 94.4%, respectively. Conclusions Given the lower frequency of nephritis and central nervous system disease and lower basal disease activity and damage scores, we could conclude that children with jSLE in Turkey have a more favorable course compared to Asian and African American children, as expected from Caucasian ethnicity.

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Juvenile systemic lupus erythematosus: onset patterns and short-term outcome in Egyptian children, a single-center experience

Abstract: Egyptian children with SLE appear to have severe disease on presentation with high SLEDAI scores and high prevalence of lupus nephritis, but respond well to therapy with a favorable short-term prognosis.

Cited by 19 publications

References 31 publications

Urinary neutrophil gelatinase-associated lipocalin and urinary soluble CXCL16 as biomarkers of activity in pediatric lupus nephritis

Urinary neutrophil gelatinase-associated lipocalin and urinary soluble CXCL16 as biomarkers of activity in pediatric lupus nephritis

Characteristics of systemic lupus erythematosus in a sample of the Egyptian population: a retrospective cohort of 1109 patients from a single center

Juvenile systemic lupus erythematosus in Turkey: demographic, clinical and laboratory features with disease activity and outcome

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