Adult- and childhood-onset systemic lupus erythematosus: a comparison of onset, clinical features, serology, and outcome

Br J Rheumatol. 1995 Sep;34(9):866-72. doi: 10.1093/rheumatology/34.9.866.


This study examines the differences which may distinguish systemic lupus erythematosus (SLE) presenting in adult life or childhood. A common database was established, with analysis of clinical, serological and outcome features of a cohort of patients with SLE, with disease diagnosed before the age of 16 (n = 39) or after the age of 16 (n = 165). Disease onset was generally more severe in the childhood-onset patients. Cardiopulmonary disease was more common in the older-onset group, but major haematological manifestations were more frequent in the childhood-onset group. Serologically, anti-DNA, anti-Sm and anti-RNP antibodies and a low C3 were all found more frequently in the younger patients. Twice as many adult-onset cases had died at the time of the last follow-up (10 vs 5%), but this group had been followed for a longer period (average 7.5 yr, S.D. 3.9 for adults vs average 4.8 yr, S.D. 3.2 for children). However, the younger patients were twice as likely (82 vs 40%) to require high-dose prednisone, although the requirement for immunosuppressive agents was similar in the two groups. Clinicians should anticipate that children with SLE have a more severe disease onset than adults in general.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Antigen-Antibody Reactions
  • Black People
  • Cohort Studies
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / epidemiology*
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / physiopathology*
  • Male
  • Survival Analysis
  • White People