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Influence of ethnicity on childhood‐onset systemic lupus erythematosus: Results from a multiethnic multicenter Canadian cohort
Author(s) -
Levy Deborah M.,
Peschken Christine A.,
Tucker Lori B.,
Chédeville Gaëlle,
Huber Adam M.,
Pope Janet E.,
Silverman Earl D.
Publication year - 2013
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.21779
Subject(s) - medicine , ethnic group , serositis , cohort , malar rash , systemic lupus erythematosus , disease , population , lupus erythematosus , pediatrics , autoantibody , immunology , anti nuclear antibody , antibody , environmental health , sociology , anthropology
Objective To determine the influence of ethnicity and sociodemographic factors on disease characteristics of the Canadian pediatric lupus population. Methods 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. Results 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. Conclusion Canadian childhood‐onset SLE patients reflect our multiethnic population, with differences in disease manifestations, autoantibody profiles, and severity of disease expression by ethnicity.