Differences and similarities between children and adults with rhupus syndrome

Abstract

Aim: In this study, we aimed to evaluate and compare the characteristics of pediatric and adult rhupus patients. Methods: Thirty pediatric patients with rhupus syndrome and 15 adult patients with rhupus syndrome were included in this study. Similarities and differences between both groups were evaluated. Results: The time elapsed between the diagnosis of juvenile idiopathic arthritis (JIA)/rheumatoid arthritis (RA) and the diagnosis of systemic lupus erythematosus (SLE) was longer in adults than in pediatric patients (p < 0.001). While the most common phenotypes at disease onset were JIA/RA in both adults and children, SLE was more prevalent in pediatric patients and RA in adult patients at the last visit (both p < 0.001). Cutaneous findings, oral ulcers, hematological and renal involvement, hypocomplementemia, and antidouble-stranded DNA positivity were more frequent in pediatric patients, whereas constitutional findings, nonscarring alopecia, neuropsychiatric involvement, and anticyclic citrullinated peptide positivity were more common in adults (all p < 0.001). Asymmetric polyarthritis was more prevalent in pediatric patients, whereas symmetric polyarthritis was more common in adult patients (both p < 0.001). Erosive arthritis was more frequently observed in adult patients (p < 0.001). In the treatment, mycophenolate mofetil was more commonly prescribed to pediatric patients, while rituximab was more frequently used for adult patients in the treatment of SLE compared to pediatric patients (both p < 0.001). Additionally, leflunomide was more commonly used in JIA/RA treatment in adult patients compared to pediatric patients (p < 0.001). Conclusion: This is the first study comparing pediatric and adult patients with rhupus syndrome. Revealing these differences and similarities will contribute significantly to the literature.