Immunological and clinical differences between juvenile and adult onset ofsystemic lupus erythematosus

Introduction: Systemic lupus erythematosus (SLE) in children usually follow s a more severe course than in adults, but sometimes in the previous studie s reported there are many confounding factors. Objective: To analyse the immunological and clinical characteristics of SLE juvenile onset and SLE adult onset. Methods: We studied 179 patients with SLE, 49 patients were aged 6-18 yrs a t onset of disease. Anti-dsDNA antibodies were detected by radioimmunoassay and antibodies to extractable nuclear antigens (ENA): anti-nRNP, anti-Sm, anti-Ro/SS-A and anti-La/SS-B antibodies by ELISA, counterimmuno-electropho resis and immunoblotting. Results: Juvenile-onset SLE shows a higher frequency of cutaneous vasculiti s (44.8% vs 27.6%; P<0.05), seizures (18.3% vs 7.6%; P < 0.05) nephropathy (67.3% vs 48.4%; P < 0.025), and discoid lupus erythematosus (26.5% vs 13.8 %; P < 0.05). The incidence of articular manifestations is lon er than in a dults (85.7% vs 96.1%; P < 0.025). No significant differences were found be tween the two groups in relation with the prevalence of antinuclear antibod ies. Conclusions: Juvenile-onset SLE has more frequent neurological and renal ma nifestations than adult-onset SLE, but immunological markers are similar in both groups. These features suggest the most severe clinical manifestation s in the juvenile-onset SLE group are not related with the presence of stud ied antibodies by different methods.