Influence of ethnicity on childhood-onset systemic lupus erythematosus: Results from a multiethnic multicenter Canadian cohort
Article first published online: 27 DEC 2012
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 1, pages 152–160, January 2013
How to Cite
Levy, D. M., Peschken, C. A., Tucker, L. B., Chédeville, G., Huber, A. M., Pope, J. E., the Canadian Network for Improved Outcomes in SLE 1000 Faces Investigators and Silverman, E. D. (2013), Influence of ethnicity on childhood-onset systemic lupus erythematosus: Results from a multiethnic multicenter Canadian cohort. Arthritis Care Res, 65: 152–160. doi: 10.1002/acr.21779
- Issue published online: 27 DEC 2012
- Article first published online: 27 DEC 2012
- Accepted manuscript online: 28 JUN 2012 09:32AM EST
- Manuscript Accepted: 16 JUN 2012
- Manuscript Received: 21 JAN 2012
- The Arthritis Society National Office. Grant Number: TAS04/0049
- Lupus Canada
- Lupus Ontario
- BC Lupus
- Arthritis and Autoimmune Research Centre Foundation
- NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: K23-AR-053202
To determine the influence of ethnicity and sociodemographic factors on disease characteristics of the Canadian pediatric lupus population.
Childhood-onset systemic lupus erythematosus (SLE) patients at 4 pediatric centers in Halifax, Montreal, Toronto, and Vancouver were consecutively recruited. Sociodemographics and disease data were collected. Patients were categorized by their primary self-selected ethnicity, and exploratory cluster analyses were examined for disease expression by ethnicity.
We enrolled 213 childhood-onset SLE patients, and ethnicity data were available for 206 patients: white (31%), Asian (30%), South Asian (15%), black (10%), Latino/Hispanic (4%), Aboriginal (4%), and Arab/Middle Eastern (3%). The frequency of clinical classification criteria (malar rash, arthritis, serositis, and renal disease) and autoantibodies significantly differed among ethnicities. Medications were prescribed equally across ethnicities: 76% were taking prednisone, 86% antimalarials, and 56% required additional immunosuppressants. Cluster analysis partitioned into 3 main groups: mild (n = 50), moderate (n = 82), and severe (n = 68) disease clusters. Only 20% of white patients were in the severe cluster compared to 51% of Asian and 41% of black patients (P = 0.03). However, disease activity indices and damage scores were similar across ethnicities.
Canadian childhood-onset SLE patients reflect our multiethnic population, with differences in disease manifestations, autoantibody profiles, and severity of disease expression by ethnicity.