Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/54935
Título: Relationship between damage and mortality in juvenile-onset systemic lupus erythematosus: Cluster analyses in a large cohort from the Spanish Society of Rheumatology Lupus Registry (RELESSER)
Autores/as: Torrente-Segarra, V.
Salman Monte, T. C.
Rúa Figueroa, I.
De Uña-Álvarez, J.
Balboa-Barreiro, V.
López-Longo, F. J.
Galindo-Izquierdo, M.
Calvo-Alén, J.
Olivé-Marqués, A.
Mouriño-Rodríguez, C.
Horcada, L.
Sánchez-Atrio, A.
Montilla, C.
Salgado, E.
Díez-Álvarez, E.
Blanco, R.
Andreu, J. L.
Fernández-Berrizbeitia, O.
Hernández-Beriain, J. A. 
Gantes, M.
Hernández-Cruz, B.
Pecondón-Español, A.
Marras, C.
Bonilla, G.
Pego-Reigosa, J. M.
Palabras clave: Cluster analysis
Juvenile Systemic Lupus Erythematosus
Organ damage, Mortality
RELESSER
Fecha de publicación: 2019
Editor/a: 0049-0172
Publicación seriada: Seminars in Arthritis and Rheumatism 
Resumen: Objectives: To identify patterns (clusters) of damage manifestation within a large cohort of juvenile SLE (jSLE) patients and evaluate their possible association with mortality. Methods: This is a multicentre, descriptive, cross-sectional study of a cohort of 345 jSLE patients from the Spanish Society of Rheumatology Lupus Registry. Organ damage was ascertained using the Systemic Lupus International Collaborating Clinics Damage Index. Using cluster analysis, groups of patients with similar patterns of damage manifestation were identified and compared. Results: Mean age (years) ± S.D. at diagnosis was 14.2 ± 2.89; 88.7% were female and 93.4% were Caucasian. Mean SLICC/ACR DI ± S.D. was 1.27 ± 1.63. A total of 12 (3.5%) patients died. Three damage clusters were identified: Cluster 1 (72.7% of patients) presented a lower number of individuals with damage (22.3% vs. 100% in Clusters 2 and 3, P < 0.001); Cluster 2 (14.5% of patients) was characterized by renal damage in 60% of patients, significantly more than Clusters 1 and 3 (P < 0.001), in addition to increased more ocular, cardiovascular and gonadal damage; Cluster 3 (12.7%) was the only group with musculoskeletal damage (100%), significantly higher than in Clusters 1 and 2 (P < 0.001). The overall mortality rate in Cluster 2 was 2.2 times higher than that in Cluster 3 and 5 times higher than that in Cluster 1 (P < 0.017 for both comparisons). Conclusions: In a large cohort of jSLE patients, renal and musculoskeletal damage manifestations were the two dominant forms of damage by which patients were sorted into clinically meaningful clusters. We found two clusters of jSLE with important clinical damage that were associated with higher rates of mortality, especially for the cluster of patients with predominant renal damage. Physicians should be particularly vigilant to the early prevention of damage in this subset of jSLE patients with kidney involvement.
URI: http://hdl.handle.net/10553/54935
ISSN: 0049-0172
DOI: 10.1016/j.semarthrit.2018.09.005
Fuente: Seminars in Arthritis and Rheumatism [ISSN 0049-0172], v. 48(6), p. 1025-1029
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