Systemic lupus erythematosus children in Egypt: Homeland spectrum amid the global situation-Reference-Cited by-同舟云学术

Systemic lupus erythematosus children in Egypt: Homeland spectrum amid the global situation

Published:2021-09-16 Issue:13 Volume:30 Page:2135-2143
ISSN:0961-2033
Container-title:Lupus
language:en
Short-container-title:Lupus

Author:

Eesa Nahla N¹,Abdel Nabi Hend²^ORCID,Owaidy Rasha El³,Khalifa Iman⁴^ORCID,Radwan Ahmed R⁵,NourEl-Din Abeer M⁶,Amer Marwa A⁷,ElShereef Rawhya R⁸,Hassan Eman⁹,Ismail Faten⁸,El-Gazzar Iman I¹,Khalil Noha M¹⁰,Moshrif Abdel Hafeez¹¹,Abualfadl Esam⁴¹²,Tharwat Samar¹³,Fathi Hanan M¹⁴,Abd Elazeem Mervat I¹⁵,El-Shebini Emad¹⁶,Samy Nermeen¹⁷,Noshy Nermeen¹⁷,El-Bahnasawy Amany S¹⁸,Abdalla Ahmed M¹⁹,Abousehly Osama S⁵,Mohamed Eman F²⁰^ORCID,Nasef Samah I²¹^ORCID,Elsaman Ahmed M⁵,ElKhalifa Marwa⁹^ORCID,Salem Mohamed N²²,Abaza Nouran M²³,Fathy Hanan M²⁴^ORCID,Abdel Salam Nancy²⁴,El-Saadany Hanan M²⁵,El-Najjar Amany R²⁶,El-Hammady Dina H²⁷,Hammam Nevin²⁸²⁹,Mohammed Reem HA¹^ORCID,Gheita Tamer A¹^ORCID,

Affiliation:

1. Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

2. Pediatrics Department, Rheumatology and Nephrology Unit, Tanta University, Gharbia, Egypt

3. Pediatrics Department, Rheumatology Unit, Ain Shams University, Cairo, Egypt

4. Pediatrics Department, Rheumatology and Nephrology Unit, Helwan University, Cairo, Egypt

5. Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt

6. Pediatrics Department, National Research Centre (NRC), Cairo, Egypt

7. Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

8. Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt

9. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Egypt

10. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt

11. Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt

12. Qena/Luxor hospitals, Qena, Egypt

13. Internal Medicine, Rheumatology Unit, Mansoura University, Dakahlia, Egypt

14. Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

15. Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

16. Internal Medicine Department, Rheumatology Unit, Menoufiya University, Menoufiya, Egypt

17. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

18. Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt

19. Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt

20. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt

21. Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt

22. Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

23. Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

24. Pediatrics Department, Rheumatology and Nephrology Unit, Alexandria University, Alexandria, Egypt

25. Rheumatology Department, Tanta University, Gharbia, Egypt

26. Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt

27. Rheumatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt

28. Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt

29. Rheumatology Department, University of California San Francisco (UCSF), San Francisco, CA, USA

Abstract

Objectives This study aims to present the manifestations of juvenile systemic lupus erythematosus (JSLE) across Egypt, to focus on age at onset and gender-driven influence on disease characteristics, and to compare findings to other countries. Methods The study included 404 Egyptian children with systemic lupus erythematosus (SLE) presenting to one of the specialized rheumatology centers corresponding to 13 major governorates. Juvenile cases age was ≤ 16°years at the time of recruitment. The SLE Disease Activity Index (SLEDAI) and damage index (DI) were assessed. Results The mean age was 13.2 ± 2.4°years; 355 females and 49 males (7.2:1), and the disease duration was 2.3 ± 1.6 years, while age at disease onset was 11.1 ± 2.5°years. Their SLEDAI was 13.5 ± 12.3, and DI, 0.36 ± 0.78. The overall estimated prevalence of childhood-SLE patients in the recruited cohort in Egypt was 1/100,000 population (0.24/100000 males and 1.8/100000 females). 7.4% developed pre-pubertal SLE (≤ 7 years); 73.3%, peri-pubertal; and 19.3% during early adolescence. The differences according to age group were equal for gender and clinical manifestations except skin lesions present in 59.3% of pre-pubertal onset, 74.6% of peri-pubertal, and 84.2% of adolescents ( p = 0.029), and renal involvement in 73.8% of peripubertal, 62.1% of pre-pubertal and 58.9% of adolescents ( p = 0.03). Laboratory investigations, SLEDAI, and DI were similar among age categories. Lupus nephritis was more common in Egypt compared to JSLE from other countries. Conclusion Our large multicenter study identified that female gender influenced disease characteristics with more frequent skin involvement. Skin lesions were significantly higher in adolescents, while renal involvement in peri-pubertal children.

Publisher

SAGE Publications

Subject

Rheumatology

Link

http://journals.sagepub.com/doi/pdf/10.1177/09612033211043010

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