AB0584 Paediatric vs adult onset systemic lupus erythematosus: the similarities and differences; a study from a tertiary care centre from northern india ‘’;+
Authors: J. Patel, M. Agarwal, A. Shivpuri, G.S. Bhandari, N. Jain, S. Sawhney, L. Duggal
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> <b>S</b>ystemic lupus erythematosus (SLE) is a chronic autoimmune disease with myriad of systemic features. While the disease manifestations and therapy remain same for both paediatric onset(cSLE) and adult onset SLE(aSLE), disease manifestation and burden of disease differs in the two populations. <h3>Objectives</h3> To study disease profile within 6 months of disease onset and burden of disease by SLEDAI of aSLE and cSLE to understand the similarities and differences and to compare with those from around the world <h3>Methods</h3> Retrospective review done of 100 aSLE and cSLE patients, from June 2015 to June 2016, fulfilling SLICC criteria. Demographic data, clinical profile and ds burden at onset(highest of 1st 6 mths of ds onset) by SLEDAI 2K were recorded on a predesigned proforma <h3>Results</h3> The incidence of skin involvement (acute and chronic cutaneous lupus, alopecia) serositis more in aSLE. Oral mucositis, neuropsychaitric SLE(NPSLE) and lupus nephritis(LN) more common in cSLE.LN was also higher in cSLE from other centres around the world as compared to aSLE. Of statistical significance were non SLICC features like fatigue, Raynaud phenomenon and fatigue in aSLE.cSLE significantly differed in higher incidence of non SLICC features like fever, vasculitic rash and in laboratory features like leucopenia, low complements, dsDNA positivity and antiphospholipid antibody(APLA) positivity. Although APLA antibodies were frequent in cSLE, thrombotic events were rare. On the other hand, thrombotic events were significantly associated with aSLE. Median SLEDAI at onset was higher in cSLE than aSLE. The higher incidence of LN in CSLE than aSLE was similar from the inception cohort from Toronto.<sup>1</sup>The mean SLEDAI at onset was also similarly higher in cSLE. The spanish SLE registry also reported similar findings.<sup>2</sup> <h3>Conclusions</h3> This study showed significant difference in initial systemic involvement and onset of presentation in aSLE and cSLE.cSLE present with more subtle features and seldom have a classic presentation with malar rash, oral mucositis and alopecia which oft herald aSLE. cSLE and aSLE though being the same disease often have a varied spectrum of presentation and the generalist and the treating teams need to be aware of these for prompt recognition of the disease and optimum therapy <h3>References</h3> [1] Brunner HI, Ibãnez D, Urowitz MD, SilvermanED. Difference in Disease Features Between Childhood-Onset and Adult-Onset Systemic Lupus Erythematosus. Arthritis and rheumatism.2008;58(2):556–62. [2] Torrente-Segarra V SMT, Rúa-Figueroa I, Alonso F, López-Longo FJ, Galindo-Izquierdo M, et al. on behalf of the RELESSER Study Group of the Spanish Society of Rheumatology (SER) and the Study Group of Systemic Autoimmune Diseases of the SER (EAS-SER). Juvenile- and adult-onset systemic lupus erythematosus:a comparative study in a large cohort from the Spanish Society of Rheumatology Lupus Registry (RELESSER). Clinical and Experimental Rheumatology2017; 35: 1047–1055 <h3>Disclosure of Interest</h3> None declared