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Distinct clinical correlates of immune thrombocytopenic purpura at diagnosis of childhood-onset and adult SLE.
Esteves, Gladys Cherres Xavier; Gormezano, Natali Weniger Spelling; Pereira, Oriany L; Kern, David; Silva, Clovis Almeida; Pereira, Rosa Maria Rodrigues; Kozu, Katia Tomie; Bonfá, Eloisa; Aikawa, Nadia Emi.
Afiliação
  • Esteves GCX; a Division of Rheumatology , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Gormezano NWS; a Division of Rheumatology , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Pereira OL; b Pediatric Rheumatology Unit , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Kern D; a Division of Rheumatology , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Silva CA; a Division of Rheumatology , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Pereira RMR; a Division of Rheumatology , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Kozu KT; b Pediatric Rheumatology Unit , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Bonfá E; a Division of Rheumatology , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
  • Aikawa NE; b Pediatric Rheumatology Unit , Faculdade de Medicina da Universidade de São Paulo (USP) , São Paulo , SP , Brazil.
Mod Rheumatol ; 28(4): 649-653, 2018 Jul.
Article em En | MEDLINE | ID: mdl-29067848
OBJECTIVES: To compare clinical and laboratorial features between childhood-onset systemic lupus erythematosus (cSLE) and adult SLE (aSLE) at concomitant diagnosis of immune thrombocytopenic purpura (ITP). METHODS: This study evaluated 56 cSLE and 73 aSLE patients regularly followed at Pediatric and Rheumatology Divisions of the same University hospital with ITP (platelets count <100,000/mm3 in the absence of other causes) at lupus onset. RESULTS: Median current age was 11.6 and 27.3 years in cSLE and aSLE, respectively. cSLE had a higher frequency of ITP compared to aSLE (17% vs. 4%, p < .0001) and the former group had more hemorrhagic manifestations (36% vs. 16%, p = .0143). Constitutional symptoms and reticuloendothelial manifestations (p < .05), as well as pericarditis (25% vs. 10%, p = .029) and central nervous system (CNS) involvement (30% vs. 14%, p = .029) were more common in cSLE. Conversely, in aSLE, ITP was solely associated with cutaneous and articular involvements (p < .05). Concerning treatment, intravenous methylprednisolone, intravenous immunoglobulin, blood transfusion and platelets transfusion were more frequently used in the cSLE population (p < .05). CONCLUSION: ITP at cSLE has distinct features compared to aSLE with a more severe presentation characterized by concomitant constitutional/reticuloendothelial manifestations, CNS involvement and hemorrhagic manifestation. These findings reinforce the need for a more aggressive treatment in this age group.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Púrpura Trombocitopênica Idiopática / Lúpus Eritematoso Sistêmico Tipo de estudo: Diagnostic_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Mod Rheumatol Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Púrpura Trombocitopênica Idiopática / Lúpus Eritematoso Sistêmico Tipo de estudo: Diagnostic_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Mod Rheumatol Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido