Background: Arthritis is one of the most common manifestations of systemic lupus erythematosus (SLE). Although\ntypically non-erosive and non-deforming, children with SLE arthritis can have significant morbidity with decreased\nquality of life. Our goal was to identify potential clinical and laboratory predictors of arthritis in a cohort of pediatric\npatients with SLE.\nMethods: We performed a cohort study of incident and prevalent patients with SLE aged ? 19 years. In cross\nsectional analysis, we compared demographic and clinical characteristics at initial clinic presentation between\npatients with arthritis noted at any time during follow-up and those without arthritis. We performed time to event\nanalysis using Cox proportional hazard ratios to identify predictors of arthritis, clustering for repeated measures.\nResults: Forty seven children and adolescents with SLE were followed in the cohort, 91 % female and 68 % Black.\nIn cross-sectional analyses, presence of malar rash was associated with arthritis. In longitudinal analyses, controlling\nfor gender and race, increased age (HR: 1.4, 95 % CI: 1.1ââ?¬â??1.7), malar rash (HR: 2.1, 95 % CI: 1.1ââ?¬â??3.6), and presence of\nRNP antibodies (HR: 1.9, 95 % CI: 1.1ââ?¬â??3.4) were predictive of arthritis. When controlling for gender, race, and medication\nuse, anemia (HR: 8.5, 95 % CI: 2.9ââ?¬â??24.2) and thrombocytopenia (HR: 6.1, 95 % CI: 2.4ââ?¬â??15.6) were associated with\nincreased risk of arthritis.\nConclusions: We identified markers predictive of arthritis in a longitudinal cohort of children with SLE. The recognition\nof these markers may help clinicians identify patients at risk for arthritis before its onset thus improving quality of life in\nchildren with SLE.
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