Juvenile Lupus May Be More Severe Than Adult Form

Juvenile-onset lupus is generally more severe than the type that begins in adulthood, according to a report in the Annals of the Rheumatic Diseases.

"We were especially surprised by the magnitude of the difference, which appears to imply a variety of disease manifestations," Dr. Dirk Elewaut from Ghent University Hospital, Ghent, Belgium, told Reuters Health.

Lupus, also known as systemic lupus erythematosus or SLE, is a chronic "autoimmune" disease in which the immune system confuses its own healthy tissues with foreign tissues and sometimes attacks both. The disorder disproportionately affects women.

The condition can vary widely in severity, manifesting as skin rash and arthritis or leading to damage to the kidneys, heart, lungs and brain to varying degrees. It is marked sometimes by a characteristic butterfly-shaped rash on the face. There is no cure.

Elewaut and colleagues investigated the occurrence of different signs, symptoms, and self-attacking antibodies in juvenile-onset SLE, compared with those in adult-onset SLE.

Patients with juvenile-onset SLE were more likely than patients with adult-onset SLE to have generalized redness, skin symptoms, and fever, but less likely to have dry eyes, dry mouth, and joint pain, the authors report.

Juvenile-onset SLE patients were also more likely to have kidney signs and symptoms and to have brain disease and anemia.

Several self-attacking antibodies were more common in juvenile-onset patients than in adult-onset patients, the researchers note.

"We intend to conduct a prospective multicenter follow-up study in juvenile SLE," Elewaut said. "In this way, we will be able to assess the evolution of (self-attacking antibodies) and disease manifestations in juvenile SLE over time."