Pancreatitis subtypes survey in 852 childhood-onset systemic lupus erythematosus patients: a multicenter cohort


Autoria(s): Marques, Victor L. S.; Gormezano, Natali W. S.; Bonfá, Eloisa; Aikawa, Nadia E.; Terreri, Maria T.; Pereira, Rosa M.; Magalhães, Claudia S.; Guariento, Andressa; Appenzeller, Simone; Ferriani, Virgínia P.; Barbosa, Cássia M.; Ramos, Valéria C.; Lotufo, Simone; Silva, Clovis A.
Contribuinte(s)

Universidade Estadual Paulista (UNESP)

Data(s)

07/12/2015

07/12/2015

22/09/2015

Resumo

Pancreatitis is a rare and a life-threatening SLE manifestation in childhood-onset systemic lupus erythematosus (c-SLE). The objective of this study was to systematically classify pancreatitis in c-SLE according to the International Study Group of Pediatric Pancreatitis (INSPPIRE) and determine the overall prevalence, clinical features, laboratory and first episode outcomes. A multicenter cohort study in 10 Pediatric Rheumatology centers, including 852 cSLE patients. Pancreatitis was diagnosed in 22/852 (2.6%) cSLE patients. It was classified as acute pancreatitis in 20 (91%), acute recurrent pancreatitis in 2 (9%) and none of them had chronic pancreatitis. None of them had gallstones, traumatic pancreatitis or reported alcohol/tobacco use. The comparison of patients with pancreatitis (first episode) and without this complication revealed a shorter disease duration [1(0-10) vs. 4(0-23) years, p < 0.0001] and higher median of SLEDAI-2K [21(0-41) vs. 2(0-45), p < 0.0001]. The frequencies of fever (p < 0.0001), weight loss (p < 0.0001), serositis (p < 0.0001), nephritis (p < 0.0001), arterial hypertension (p < 0.0001), acute renal failure (p < 0.0001), macrophage activation syndrome (p < 0.0001) and death (p = 0.001) were also higher in patients with pancreatitis. The frequencies of intravenous methylprednisolone use (p < 0.0001) and the median of prednisone dose [55(15-60) vs. 11(1-90)mg/day, p < 0.0001] were significantly higher in patients with pancreatitis. Of note, the two patients with acute recurrent pancreatitis had two episodes, with pain-free interval of 1 and 4 years. This was the first study characterizing pancreatitis using the INSPPIRE standardized definitions in patients with cSLE showing that the predominant form is acute pancreatitis seen in association with glucocorticoid treatment and active severe disease.

Formato

1-18

Identificador

http://dx.doi.org/10.1097/MPG.0000000000000990

Journal Of Pediatric Gastroenterology And Nutrition, p. 1-18, 2015.

1536-4801

http://hdl.handle.net/11449/131599

10.1097/MPG.0000000000000990

26418213

Idioma(s)

eng

Relação

Journal Of Pediatric Gastroenterology And Nutrition

Direitos

closedAccess

Tipo

info:eu-repo/semantics/article