Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1016/j.rbre.2017.09.002 http://hdl.handle.net/11449/163567 |
Resumo: | Objectives: To assess clinical digital vasculitis (DV) as an initial manifestation of childhood onset systemic lupus erythematosus (cSLE) within a large population. Methods: Multicenter cross-sectional study including 852 cSLE patients (ACR criteria) followed in ten Pediatric Rheumatology centers in Sao Paulo State, Brazil. Results: DV was observed in 25/852 (3%) cSLE patients. Periungual hemorrhage was diagnosed in 12 (48%), periungual infarction in 7 (28%), tip finger ulceration in 4 (16%), painful nodules in 1 (4%) and gangrene in 1 (4%). A poor outcome, with digital resorption, occurred in 5 (20%). Comparison of patients with and without DV revealed higher frequency of malar rash (80% vs. 53%, p = 0.008), discoid rash (16% vs. 4%, p = 0.017), photosensitivity (76% vs. 45%, p = 0.002) and other cutaneous vasculitides (80% vs. 19%, p <0.0001), whereas the frequency of overall constitutional features (32% vs. 61%, p = 0.003), fever (32% vs. 56%, p = 0.020) and hepatomegaly (4% vs. 23%, p = 0.026) were lower in these patients. Frequency of female gender, severe multi-organ involvement, autoantibodies profile and low complement were alike in both groups (p >0.05). SLEDAI-2K median, DV descriptor excluded, was significantly lower in patients with DV compared to those without this manifestation [10 (0-28) vs. 14 (0-58), p = 0.004]. Visceral vasculitis or death were not observed in this cSLE cohort. The frequency of cyclophosphamide use (0% vs. 18%, p = 0.014) was significantly lower in the DV group. Conclusion: Our large multicenter study identified clinical DV as one of the rare initial manifestation of active cSLE associated with a mild multisystemic disease, in spite of digital resorption in some of these patients. (C) 2017 Published by Elsevier Editora Ltda. |
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Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosusDigital vasculitisChildhood-onset systemic lupus erythematosusVasculitisSledai-2KObjectives: To assess clinical digital vasculitis (DV) as an initial manifestation of childhood onset systemic lupus erythematosus (cSLE) within a large population. Methods: Multicenter cross-sectional study including 852 cSLE patients (ACR criteria) followed in ten Pediatric Rheumatology centers in Sao Paulo State, Brazil. Results: DV was observed in 25/852 (3%) cSLE patients. Periungual hemorrhage was diagnosed in 12 (48%), periungual infarction in 7 (28%), tip finger ulceration in 4 (16%), painful nodules in 1 (4%) and gangrene in 1 (4%). A poor outcome, with digital resorption, occurred in 5 (20%). Comparison of patients with and without DV revealed higher frequency of malar rash (80% vs. 53%, p = 0.008), discoid rash (16% vs. 4%, p = 0.017), photosensitivity (76% vs. 45%, p = 0.002) and other cutaneous vasculitides (80% vs. 19%, p <0.0001), whereas the frequency of overall constitutional features (32% vs. 61%, p = 0.003), fever (32% vs. 56%, p = 0.020) and hepatomegaly (4% vs. 23%, p = 0.026) were lower in these patients. Frequency of female gender, severe multi-organ involvement, autoantibodies profile and low complement were alike in both groups (p >0.05). SLEDAI-2K median, DV descriptor excluded, was significantly lower in patients with DV compared to those without this manifestation [10 (0-28) vs. 14 (0-58), p = 0.004]. Visceral vasculitis or death were not observed in this cSLE cohort. The frequency of cyclophosphamide use (0% vs. 18%, p = 0.014) was significantly lower in the DV group. Conclusion: Our large multicenter study identified clinical DV as one of the rare initial manifestation of active cSLE associated with a mild multisystemic disease, in spite of digital resorption in some of these patients. (C) 2017 Published by Elsevier Editora Ltda.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Federico FoundationNucleo de Apoio a Pesquisa Saude da Crianca e do Adolescente of USP (NAP-CriAd)Univ Fed Sao Paulo UNIFESP, Unidade Reumatol Pediat, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Unidade Reumatol Pediat, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Div Reumatol, Sao Paulo, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Hosp Clin Botucatu, Botucatu, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Hosp Clin Botucatu, Botucatu, SP, BrazilCNPq: CNPq 303422/2015-7CNPq: 301805/2013-0CNPq: 305068/2014-8CNPq: 301479/2015CNPq: 303752/2015-7Elsevier B.V.Universidade Federal de São Paulo (UNIFESP)Universidade de São Paulo (USP)Universidade Estadual Paulista (Unesp)Sakamoto, Ana PaulaSilva, Clovis ArturCastro da Silva, Marco FelipeLopes, Anandreia SimoesSouza Russo, Gleice ClementeElias Sallum, Adriana MalufKozu, KatiaBonfa, EloisaSaad-Magalhaes, Claudia [UNESP]Rodrigues Pereira, Rosa MariaLen, Claudio ArnaldoTerreri, Maria Teresa2018-11-26T17:42:33Z2018-11-26T17:42:33Z2017-11-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article583-589application/pdfhttp://dx.doi.org/10.1016/j.rbre.2017.09.002Revista Brasileira De Reumatologia. New York: Elsevier Science Inc, v. 57, n. 6, p. 583-589, 2017.0482-5004http://hdl.handle.net/11449/16356710.1016/j.rbre.2017.09.002WOS:000417146600011WOS000417146600011.pdf70983100083716320000-0002-7631-7093Web of Sciencereponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengRevista Brasileira De Reumatologia0,340info:eu-repo/semantics/openAccess2023-11-16T06:13:13Zoai:repositorio.unesp.br:11449/163567Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T17:51:58.884297Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus |
title |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus |
spellingShingle |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus Sakamoto, Ana Paula Digital vasculitis Childhood-onset systemic lupus erythematosus Vasculitis Sledai-2K |
title_short |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus |
title_full |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus |
title_fullStr |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus |
title_full_unstemmed |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus |
title_sort |
Initial digital vasculitis in a large multicenter cohort of childhood-onset systemic lupus erythematosus |
author |
Sakamoto, Ana Paula |
author_facet |
Sakamoto, Ana Paula Silva, Clovis Artur Castro da Silva, Marco Felipe Lopes, Anandreia Simoes Souza Russo, Gleice Clemente Elias Sallum, Adriana Maluf Kozu, Katia Bonfa, Eloisa Saad-Magalhaes, Claudia [UNESP] Rodrigues Pereira, Rosa Maria Len, Claudio Arnaldo Terreri, Maria Teresa |
author_role |
author |
author2 |
Silva, Clovis Artur Castro da Silva, Marco Felipe Lopes, Anandreia Simoes Souza Russo, Gleice Clemente Elias Sallum, Adriana Maluf Kozu, Katia Bonfa, Eloisa Saad-Magalhaes, Claudia [UNESP] Rodrigues Pereira, Rosa Maria Len, Claudio Arnaldo Terreri, Maria Teresa |
author2_role |
author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Universidade de São Paulo (USP) Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Sakamoto, Ana Paula Silva, Clovis Artur Castro da Silva, Marco Felipe Lopes, Anandreia Simoes Souza Russo, Gleice Clemente Elias Sallum, Adriana Maluf Kozu, Katia Bonfa, Eloisa Saad-Magalhaes, Claudia [UNESP] Rodrigues Pereira, Rosa Maria Len, Claudio Arnaldo Terreri, Maria Teresa |
dc.subject.por.fl_str_mv |
Digital vasculitis Childhood-onset systemic lupus erythematosus Vasculitis Sledai-2K |
topic |
Digital vasculitis Childhood-onset systemic lupus erythematosus Vasculitis Sledai-2K |
description |
Objectives: To assess clinical digital vasculitis (DV) as an initial manifestation of childhood onset systemic lupus erythematosus (cSLE) within a large population. Methods: Multicenter cross-sectional study including 852 cSLE patients (ACR criteria) followed in ten Pediatric Rheumatology centers in Sao Paulo State, Brazil. Results: DV was observed in 25/852 (3%) cSLE patients. Periungual hemorrhage was diagnosed in 12 (48%), periungual infarction in 7 (28%), tip finger ulceration in 4 (16%), painful nodules in 1 (4%) and gangrene in 1 (4%). A poor outcome, with digital resorption, occurred in 5 (20%). Comparison of patients with and without DV revealed higher frequency of malar rash (80% vs. 53%, p = 0.008), discoid rash (16% vs. 4%, p = 0.017), photosensitivity (76% vs. 45%, p = 0.002) and other cutaneous vasculitides (80% vs. 19%, p <0.0001), whereas the frequency of overall constitutional features (32% vs. 61%, p = 0.003), fever (32% vs. 56%, p = 0.020) and hepatomegaly (4% vs. 23%, p = 0.026) were lower in these patients. Frequency of female gender, severe multi-organ involvement, autoantibodies profile and low complement were alike in both groups (p >0.05). SLEDAI-2K median, DV descriptor excluded, was significantly lower in patients with DV compared to those without this manifestation [10 (0-28) vs. 14 (0-58), p = 0.004]. Visceral vasculitis or death were not observed in this cSLE cohort. The frequency of cyclophosphamide use (0% vs. 18%, p = 0.014) was significantly lower in the DV group. Conclusion: Our large multicenter study identified clinical DV as one of the rare initial manifestation of active cSLE associated with a mild multisystemic disease, in spite of digital resorption in some of these patients. (C) 2017 Published by Elsevier Editora Ltda. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-11-01 2018-11-26T17:42:33Z 2018-11-26T17:42:33Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1016/j.rbre.2017.09.002 Revista Brasileira De Reumatologia. New York: Elsevier Science Inc, v. 57, n. 6, p. 583-589, 2017. 0482-5004 http://hdl.handle.net/11449/163567 10.1016/j.rbre.2017.09.002 WOS:000417146600011 WOS000417146600011.pdf 7098310008371632 0000-0002-7631-7093 |
url |
http://dx.doi.org/10.1016/j.rbre.2017.09.002 http://hdl.handle.net/11449/163567 |
identifier_str_mv |
Revista Brasileira De Reumatologia. New York: Elsevier Science Inc, v. 57, n. 6, p. 583-589, 2017. 0482-5004 10.1016/j.rbre.2017.09.002 WOS:000417146600011 WOS000417146600011.pdf 7098310008371632 0000-0002-7631-7093 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Revista Brasileira De Reumatologia 0,340 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
583-589 application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier B.V. |
publisher.none.fl_str_mv |
Elsevier B.V. |
dc.source.none.fl_str_mv |
Web of Science reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808128868540743680 |