BOSTON — Children with systemic lupus erythematosus appear to have favorable outcomes, at least in the short term, according to findings of an Israel-based study.
Yosef Uziel, M.D., of Meir Hospital in Kfar-Saba, Israel, and colleagues, retrospectively analyzed the records of all pediatric patients with SLE in an Israeli national registry of children with rheumatic diseases.
They presented their findings on 102 children who were followed for the first 5 years of their disease in a poster session at the annual meeting of the Federation of Clinical Immunological Societies in Boston.
On average, the patients were 13 years old at the time of diagnosis; 81% were female. Initially, 41% had renal involvement; 7% central nervous system problems; 94% hematologic abnormalities; 49% malar rashes; 21% oral or nasal ulcerations; 45% musculoskeletal disorders; and 16% serositis. Their initial mean SLE disease activity index (SLEDAI) score was 17.2.
At the time of their diagnosis, 80% of the children received prescriptions for corticosteroids. Nineteen percent received immunosuppressive drugs.
Five-year data were available on 44 of the children. Of these, 73% were on corticosteroids, and 38% were on immunosuppressive drugs.
The mean SLEDAI score dropped precipitously to 8.2 a year after diagnosis, and disease scores remained relatively stable, falling to a mean of 6.7 at 5 years.
Use of immunosuppressives consistently increased between the 1- and 5-year marks.
According to Dr. Uziel, some children took immunosuppressives as steroid-sparing agents, others for severe organ involvement, including lung, kidney, and central nervous system problems. Five patients developed chronic renal failure. One died.