Childhood-onset systemic lupus erythematosus and immune thrombocytopenia: Prevalence and risk factors

Pediatr Blood Cancer. 2021 Aug;68(8):e29146. doi: 10.1002/pbc.29146. Epub 2021 May 27.

Abstract

Background: There are few studies examining the prevalence and clinical risk factors for subsequent systemic lupus erythematosus (SLE) development after long-term follow-up in childhood immune thrombocytopenia (ITP). The aims of this study were to evaluate the prevalence and risk factors for subsequent SLE development in childhood ITP.

Methods: The medical records of childhood ITP patients aged under 15 years in a major tertiary care center in Southern Thailand were retrospectively reviewed. The Kaplan-Meier method was used to estimate the cumulative probability of subsequent SLE development after ITP. Logistic regression analysis was used to identify independent risk factors for SLE development.

Results: A total of 473 childhood ITP cases were included in the study. During a mean follow-up time of 6.1 ± 6.7 years, the prevalence of subsequent SLE development was 2.96%. Older age at ITP diagnosis (odds ratio [OR]: 1.24, 95% CI: 1.07-1.45) and chronic ITP (OR: 24.67, 95% CI: 3.14-100.0) were independent risk factors. The cumulative probabilities of subsequently developing SLE at 5 and 10 years after diagnosis of ITP were 3.8% (95% CI: 1.4-6.2) and 6.5% (95% CI: 2.9-9.8), respectively.

Conclusion: Older age at ITP diagnosis and chronic ITP were risk factors for subsequent SLE developed in childhood ITP.

Keywords: immune thrombocytopenia; risk factors; systemic lupus erythematosus.

MeSH terms

  • Adolescent
  • Aftercare
  • Child
  • Humans
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / epidemiology
  • Prevalence
  • Purpura, Thrombocytopenic, Idiopathic* / epidemiology
  • Purpura, Thrombocytopenic, Idiopathic* / etiology
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers
  • Thailand / epidemiology