Uveitis in childhood-onset systemic lupus erythematosus patients: a multicenter survey

Abstract

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.

Epidemiology of disease-activity related ophthalmological manifestations in Systemic Lupus Erythematosus: A systematic review

“…In the large study by Kahwage et al, 48 the overall prevalence of posterior uveitis was 0.59% [5/852] compared to 0.16% in the general population 59 ).…”

Epidemiological and advanced therapeutic approaches to treatment of uveitis in pediatric rheumatic diseases: a systematic review and meta-analysis

“…To assess different epidemiological aspects of uveitis in pediatric rheumatic diseases based on the applied keywords,19 out of 128 studies focused on the different epidemiological aspects of uveitis in pediatric rheumatic diseases and 4 were excluded due to lack of adequate information, and 2 were excluded due to lack of full text, or review article in nature. Finally, 13 studies published between 1997 and 2017 met the endpoints that were analyzed [7][8][9][10][11][12][13][14][15][16][17][18][19] (Table 1).…”

Epidemiology and management practices for childhood-onset systemic lupus erythematosus patients: a survey in Latin America

“…LA includes 33 countries and dependencies, a large population, two main languages (Spanish and Portuguese), with distinct socio-economic and political status. Two groups have reported data focused on epidemiology, clinical and laboratorial features of cSLE patients in LA: BRAC-SLE (Brazilian Childhood-onset SLE Registry Group) [2][3][4][5][6][7][8][9][10][11][12][13][14][15] and GLADEL (Grupo Latino Americano De Estudio del Lupus) [16][17][18][19].…”