Mayo Clinic, Rochester, Minnesota.
University of Maryland Medical Center, Baltimore.
Arthritis Care Res (Hoboken). 2022 May;74(5):728-732. doi: 10.1002/acr.24827. Epub 2022 Feb 22.
To characterize the incidence and prevalence of childhood-onset systemic lupus erythematosus (SLE), and to estimate the proportion of patients who are diagnosed with SLE during childhood.
A cohort of patients with incident childhood-onset SLE from 1976 to 2018 from an 8-county region in the US were identified based on comprehensive medical record review. All patients met the European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) classification criteria for SLE or the ACR SLE classification criteria from 1997 at or before age 18 years. Incidence rates were estimated using Poisson methods. We estimated the childhood-onset SLE point prevalence for January 1, 2015. Results were sex and age adjusted to the US 2000 population. Among all the SLE patients living in the 8-county region on January 1, 2015, the proportion of patients diagnosed at ≤18 years was estimated.
A total of 13 children were diagnosed with childhood-onset SLE during the study period (using the EULAR/ACR definition; mean age at diagnosis 15.1 years, 85% female, 69% White). Childhood-onset SLE overall adjusted incidence rate was 0.7 (95% confidence interval [95% CI] 0.2-1.1) per 100,000 children. The incidence rate in girls was 1.2 (95% CI 0.5-1.9) per 100,000 children, while in boys it was 0.2 (95% CI 0.0-0.5) per 100,000. The adjusted prevalence of childhood-onset SLE was 1.1 (95% CI 0.0-3.1) per 100,000 children. The proportion of patients with SLE diagnosed as children was 9% (95% CI 6-13%).
In this population-based study, both the incidence and prevalence rates of childhood-onset SLE were ~1 per 100,000 children. One in 10 adults with SLE was diagnosed in childhood. More studies are needed to further characterize the epidemiology of childhood-onset SLE in minorities.
描述儿童发病系统性红斑狼疮（SLE）的发病率和患病率，并估计在儿童时期被诊断为 SLE 的患者比例。
基于全面的病历回顾，我们在美国一个 8 个县的地区确定了 1976 年至 2018 年期间患有儿童发病系统性红斑狼疮的患者队列。所有患者均符合欧洲抗风湿病联盟（EULAR）/美国风湿病学会（ACR）SLE 分类标准或 1997 年之前年龄在 18 岁以下的 ACR SLE 分类标准。发病率采用泊松方法估计。我们估计了 2015 年 1 月 1 日的儿童发病 SLE 点患病率。结果根据美国 2000 年人口进行了性别和年龄调整。在 2015 年 1 月 1 日居住在该 8 个县的所有 SLE 患者中，估计了在≤18 岁时被诊断出的患者比例。
在研究期间，共有 13 名儿童被诊断为儿童发病 SLE（使用 EULAR/ACR 定义；诊断时的平均年龄为 15.1 岁，85%为女性，69%为白人）。儿童发病 SLE 的总调整发病率为 0.7（95%置信区间[95%CI]0.2-1.1）/100,000 儿童。女孩的发病率为 1.2（95%CI0.5-1.9）/100,000 儿童，而男孩为 0.2（95%CI0.0-0.5）/100,000。儿童发病 SLE 的调整后患病率为 1.1（95%CI0.0-3.1）/100,000 儿童。被诊断为儿童 SLE 的患者比例为 9%（95%CI6-13%）。
在这项基于人群的研究中，儿童发病 SLE 的发病率和患病率均为~1/100,000 儿童。每 10 名成人 SLE 患者中就有 1 名在儿童时期被诊断。需要进一步开展研究以更好地描述少数民族儿童发病 SLE 的流行病学。
