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儿童发病系统性红斑狼疮和免疫性血小板减少症:患病率和危险因素。

Childhood-onset systemic lupus erythematosus and immune thrombocytopenia: Prevalence and risk factors.

机构信息

Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.

Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.

出版信息

Pediatr Blood Cancer. 2021 Aug;68(8):e29146. doi: 10.1002/pbc.29146. Epub 2021 May 27.

Abstract

BACKGROUND

There are few studies examining the prevalence and clinical risk factors for subsequent systemic lupus erythematosus (SLE) development after long-term follow-up in childhood immune thrombocytopenia (ITP). The aims of this study were to evaluate the prevalence and risk factors for subsequent SLE development in childhood ITP.

METHODS

The medical records of childhood ITP patients aged under 15 years in a major tertiary care center in Southern Thailand were retrospectively reviewed. The Kaplan-Meier method was used to estimate the cumulative probability of subsequent SLE development after ITP. Logistic regression analysis was used to identify independent risk factors for SLE development.

RESULTS

A total of 473 childhood ITP cases were included in the study. During a mean follow-up time of 6.1 ± 6.7 years, the prevalence of subsequent SLE development was 2.96%. Older age at ITP diagnosis (odds ratio [OR]: 1.24, 95% CI: 1.07-1.45) and chronic ITP (OR: 24.67, 95% CI: 3.14-100.0) were independent risk factors. The cumulative probabilities of subsequently developing SLE at 5 and 10 years after diagnosis of ITP were 3.8% (95% CI: 1.4-6.2) and 6.5% (95% CI: 2.9-9.8), respectively.

CONCLUSION

Older age at ITP diagnosis and chronic ITP were risk factors for subsequent SLE developed in childhood ITP.

摘要

背景

在儿童免疫性血小板减少症(ITP)长期随访后,鲜有研究探讨随后发生系统性红斑狼疮(SLE)的患病率和临床危险因素。本研究旨在评估儿童 ITP 后发生 SLE 的患病率和危险因素。

方法

回顾性分析泰国南部一家主要三级保健中心的 15 岁以下儿童 ITP 患者的病历。采用 Kaplan-Meier 法估计 ITP 后 SLE 发展的累积概率。采用 logistic 回归分析确定 SLE 发展的独立危险因素。

结果

本研究共纳入 473 例儿童 ITP 病例。平均随访时间为 6.1±6.7 年,SLE 发展的患病率为 2.96%。ITP 诊断时年龄较大(优势比 [OR]:1.24,95%置信区间 [CI]:1.07-1.45)和慢性 ITP(OR:24.67,95% CI:3.14-100.0)是独立的危险因素。ITP 诊断后 5 年和 10 年发生 SLE 的累积概率分别为 3.8%(95% CI:1.4-6.2)和 6.5%(95% CI:2.9-9.8)。

结论

ITP 诊断时年龄较大和慢性 ITP 是儿童 ITP 后发生 SLE 的危险因素。

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