Childhood-onset systemic lupus erythematosus in Croatia: demographic, clinical and laboratory features, and factors influencing time to diagnosis

Lukić, Anita and Lukić, Ivan Krešimir and Malčić, Ivan and Batinić, Danica and Milošević, Danko and Rožmanić, Vojko and Saraga, Marijan and Šubat-Dežulović, Mirna and Metličić, Vitomir and Malenica, Branko and Jelušić, Marija (2013) Childhood-onset systemic lupus erythematosus in Croatia: demographic, clinical and laboratory features, and factors influencing time to diagnosis. Clinical and Experimental Rheumatology, 31 (5). pp. 803-812. ISSN 0392-856X

[img] PDF - Published Version
Download (387kB)


OBJECTIVES Childhood-onset systemic lupus erythematosus (cSLE) presents with diverse clinical features and often with non-classical symptoms that may delay diagnosis and increase risk of morbidity and mortality. This paper aims to analyse incidence, and clinical and laboratory features of cSLE in Croatia between 1991 and 2010, and to identify factors influencing time to diagnosis. ----- RESULTS Medical records at three university-based tertiary care centres were analysed retrospectively for 81 children with cSLE (68 girls). Mean age at onset was 13.4±2.8 yr (interquartile range 3), and annual incidence varied from 1-15 per million at risk. The most frequent clinical and laboratory features were musculoskeletal symptoms (80%) and increased erythrocyte sedimentation rate (96%). The most frequent immunological laboratory findings were the presence of antibodies against histones (86%), double-stranded DNA (73%), and Sm protein (64%), as well as low levels of C3 complement (69%). Haematuria was present in 58% of children, proteinuria in 56%, and biopsy-confirmed lupus nephritis in 43%. Median time from symptom onset to diagnosis was 2 months (range 0-96). Time to diagnosis was inversely associated with ECLAM score (p<0.001), but it showed no association with age, gender, clinical features or distance from the nearest paediatric centre. ----- CONCLUSIONS This is the first large-scale, in-depth study of clinical and laboratory features of cSLE in Croatia. Among all demographic, laboratory and clinical features examined, ECLAM score alone was inversely associated with time to diagnosis. This highlights the need to improve detection of children with fewer symptoms early in the course of the disease, therefore serious consequences for prognosis could be avoided.

Item Type: Article
Additional Information: © Clinical and Experimental Rheumatology
MeSH: Adolescent ; Age of Onset ; Chi-Square Distribution ; Child ; Croatia/epidemiology ; Delayed Diagnosis ; Female ; Humans ; Incidence ; Lupus Erythematosus, Systemic/blood ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/epidemiology ; Lupus Erythematosus, Systemic/immunology ; Male ; Predictive Value of Tests ; Retrospective Studies ; Tertiary Care Centers ; Time Factors
Departments: Katedra za pedijatriju
Depositing User: Marijan Šember
Status: Published
Lukić, Ivan KrešimirUNSPECIFIED
Batinić, DanicaUNSPECIFIED
Milošević, DankoUNSPECIFIED
Rožmanić, VojkoUNSPECIFIED
Saraga, MarijanUNSPECIFIED
Šubat-Dežulović, MirnaUNSPECIFIED
Metličić, VitomirUNSPECIFIED
Malenica, BrankoUNSPECIFIED
Jelušić, MarijaUNSPECIFIED
Date: September 2013
Date Deposited: 23 Feb 2016 13:02
Last Modified: 13 Jul 2020 10:59
Subjects: /
Related URLs:

Actions (login required)

View Item View Item


Downloads per month over past year