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Increased incidence of juvenile-onset systemic lupus erythematosus among children with asthma

Authors

  • Chang-Ching Wei,

    1. Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan
    2. College of Medicine, China Medical University, Taichung, Taiwan
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  • Cheng-Li Lin,

    1. College of Medicine, China Medical University, Taichung, Taiwan
    2. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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  • Te-Chun Shen,

    1. College of Medicine, China Medical University, Taichung, Taiwan
    2. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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  • Jeng-Dau Tsai,

    1. Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • Chi-Jung Chung,

    Corresponding author
    1. Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan
    2. Department of Medical Research, China Medical University and Hospital, Taichung, Taiwan
    • Correspondence

      Chi-Jung Chung, Department of Health Risk Management, College of Public Health, China Medical University; #91 Hsueh-Shih Road, Taichung City 404, Taiwan

      Tel.: +886-4-2205-3366 ext. 6505

      Fax: +886-4-2207-0429

      E-mail: cjchung@mail.cmu.edu.tw

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  • Tsai-Chung Li

    1. Biostatistics Center, China Medical University & Hospital, Taichung, Taiwan
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Abstract

Background

Children with systemic lupus erythematosus (SLE) have an especially aggressive disease course and poor outcomes. Previous studies demonstrated a possible association between SLE and allergies, but the relationship between these disorders remains unclear. This population-based cohort study aimed to investigate the incidence and risk of juvenile-onset SLE (JSLE) among children with asthma.

Methods

From 2000 to 2003, 120,939 children with newly diagnosed asthma and 483,756 randomly selected non-asthma controls were enrolled. We used a multivariable Cox proportional hazard regression model to measure and compare the incidence rate and risk of JSLE in the asthma and non-asthma cohorts.

Results

The overall incidence of JSLE was 2.52 times greater in the asthma cohort than that in the non-asthma cohort [3.49 vs. 1.53 per 100,000 person-years; 95% confidence interval (CI): 1.59–3.99]. The risk of JSLE was greatest among boys [hazard ratio (HR) 3.02, 95% CI: 1.21–7.52] and children aged 6–10 yr (HR 3.50, 95% CI: 1.75–7.02). The HR of JSLE increased with greater frequency of asthma-related medical visits from 1.22 (95% CI: 0.67–1.41) for those with ≤2 visits/yr to 5.88 (95% CI: 3.43–10.1) for subjects with >2 visits/yr (trend test p < 0.001). However, the risk of JSLE declined over time.

Conclusion

We found an increased incidence of JSLE among children with asthma. The mechanism of asthma on JSLE development should be elucidated to establish innovative disease intervention programs.

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