Systemic lupus international collaborating clinics-2012 and European league against rheumatism/American college of rheumatology-2019 classification criteria for systemic lupus erythematosus associated with childhood-onset auto-immune cytopenia.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY Lupus Pub Date : 2024-10-22 DOI:10.1177/09612033241296471
Jérôme Granel, Helder Fernandes, Olivier Richer, Johanna Clet, Mathilde Dubrasquet, Pascal Pillet, Nathalie Aladjidi
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Abstract

Introduction: Systemic Lupus Erythematosus (SLE) can be diagnosed using the 2012 criteria of the Systemic Lupus International Collaborating Clinics (SLICC) and, more recently, the 2019 criteria of the European League Against Rheumatism/American College of Rheumatology (EULAR/ACR). Hematological involvement is scored differently by these classifications. Our objective was to compare both criteria in a cohort of children with autoimmune cytopenia (AIC)-associated SLE.

Method: We included 79 patients with childhood-onset AIC as the first manifestations of SLE.

Results: The median age at SLE diagnosis was 14.5 years (1.1-21.4 years). The SLICC criteria were fulfilled by 76/79 (96%) patients and the EULAR/ACR criteria by 72/79 (91%) patients during follow-up. The SLICC and EULAR/ACR criteria were discordant (not concomitantly fulfilled) in 25/79 (32%) patients. Non-hematological clinical manifestations were more frequently observed in SLE diagnosis when the criteria were concordant (30/54, 56%) than when they were not (5/25, 20%) (p = 0.004). In 16/25 (64%) discordant patients, the SLICC criteria allowed earlier diagnosis of SLE. Finally, the attribution of a maximum weight of 6 to the hematological involvement of the EULAR/ACR criteria increased the sensitivity thereof from 63/79 (80%) to 76/79 (96%) in our population.

Conclusion: The SLICC 2012 and EULAR/ACR 2019 criteria do not effectively diagnose SLE in children when AIC is the predominant feature. The SLICC criteria appear to be more effective in this population of SLE patients. An increase in the maximum weight of hematological involvement to 6 increases the sensitivity of the EULAR/ACR criteria for SLE diagnosis in children.

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系统性红斑狼疮国际合作诊所-2012 和欧洲抗风湿病联盟/美国风湿病学会-2019 系统性红斑狼疮伴发儿童期自身免疫细胞减少症分类标准。
导言:系统性红斑狼疮(SLE)的诊断可采用系统性红斑狼疮国际合作诊所(SLICC)2012 年的标准以及最近欧洲抗风湿联盟/美国风湿病学会(EULAR/ACR)2019 年的标准。这些分类标准对血液学受累的评分有所不同。我们的目的是在一组自身免疫细胞减少症(AIC)相关系统性红斑狼疮儿童患者中比较这两种标准:方法:我们纳入了79名以儿童期AIC为首发表现的系统性红斑狼疮患者:结果:确诊系统性红斑狼疮时的中位年龄为 14.5 岁(1.1-21.4 岁)。随访期间,76/79(96%)名患者符合SLICC标准,72/79(91%)名患者符合EULAR/ACR标准。25/79(32%)名患者不符合SLICC和EULAR/ACR标准(不同时符合)。在系统性红斑狼疮诊断中,标准一致时(30/54,56%)出现非血液学临床表现的比例高于标准不一致时(5/25,20%)(P = 0.004)。在 16/25 例(64%)标准不一致的患者中,SLICC 标准允许更早地诊断出系统性红斑狼疮。最后,将EULAR/ACR标准中血液学受累的最大权重定为6,在我们的人群中,灵敏度从63/79(80%)提高到76/79(96%):结论:当AIC是主要特征时,SLICC 2012和EULAR/ACR 2019标准不能有效诊断儿童系统性红斑狼疮。SLICC标准似乎对这部分系统性红斑狼疮患者更有效。将血液学受累的最大权重增加到6,可提高EULAR/ACR标准诊断儿童系统性红斑狼疮的灵敏度。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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