Sampaio-Barros Percival D, Bortoluzzo Adriana B, Del Rio Ana Paula T, Luppino-Assad Ana Paula, Andrade Danieli Co, Marques-Neto João Francisco
Division of Rheumatology Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil.
Insper (Institute of Education and Research), São Paulo, Brazil.
J Scleroderma Relat Disord. 2019 Feb;4(1):43-48. doi: 10.1177/2397198318769796. Epub 2018 Apr 24.
To characterize the clinical and laboratory profile of juvenile-onset compared to adult-onset systemic sclerosis in a large Brazilian cohort.
Retrospective analysis of a cohort of 1016 systemic sclerosis patients followed at the Scleroderma Outpatient Clinic from two referral university centers in Brazil. Patients were classified as systemic sclerosis according to the 1980 American College of Rhaumatology (ACR) criteria. Juvenile-onset systemic sclerosis was defined if age at onset was <16 years.
Thirty-one (3.1%) patients were classified as juvenile-onset systemic sclerosis. These patients were predominantly females (90.3%), Caucasians (71.0%), and presented diffuse systemic sclerosis (51.6%), with mean age at onset of 12.71 years. Compared to the adult-onset patients, juvenile onset was associated with diffuse systemic sclerosis (p < 0.001), calcinosis (p < 0.001), myositis (p = 0.050), and lower frequency of interstitial lung disease (p = 0.050), pulmonary hypertension (p = 0.035), and esophageal (p = 0.005) involvement.
Juvenile-onset systemic sclerosis characterized a distinct clinical pattern in this large series of systemic sclerosis patients, since it was predominantly associated with diffuse systemic sclerosis without significant organ involvement.
在一个大型巴西队列中,描述青少年起病型与成人起病型系统性硬化症的临床和实验室特征。
对来自巴西两个转诊大学中心的硬皮病门诊随访的1016例系统性硬化症患者队列进行回顾性分析。根据1980年美国风湿病学会(ACR)标准将患者分类为系统性硬化症。如果发病年龄<16岁,则定义为青少年起病型系统性硬化症。
31例(3.1%)患者被分类为青少年起病型系统性硬化症。这些患者主要为女性(90.3%)、白种人(71.0%),表现为弥漫性系统性硬化症(51.6%),平均发病年龄为12.71岁。与成人起病型患者相比,青少年起病与弥漫性系统性硬化症(p<0.001)、钙质沉着(p<0.001)、肌炎(p=0.050)以及间质性肺病(p=0.050)、肺动脉高压(p=0.035)和食管受累(p=0.005)的较低发生率相关。
在这一大系列系统性硬化症患者中,青少年起病型系统性硬化症具有独特的临床模式,因为它主要与弥漫性系统性硬化症相关,且无明显器官受累。