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Objectives Juvenile-onset systemic lupus erythematosus (SLE) represents a more severe form of the disease. This study aims to describe the clinical and biological characteristics of juvenile-onset SLE and to compare them with those of adult-onset SLE.Methods We conducted a retrospective, single-center study including juvenile-onset (aged 19 years or younger) and adult-onset (aged 20 years or older) SLE patients followed between 2011 and 2022 at the Department of Internal Medicine, Ibn Sina University Hospital, Rabat. Clinical, biological, and treatment characteristics were compared. Analyses were performed using univariate and multivariate regression models.Results Overall, 64 juvenile-onset (90.6% women) and 305 adult-onset (91.8% women) SLE patients were included. The mean age at diagnosis was 15.6 ± 3.4 years in the juvenile-onset group and 34.8 ± 11.5 years in the adult-onset group. Juvenile-onset patients exhibited a longer diagnostic delay (p < 0.04), more frequent malar rash, discoid lesions, hematuria, chronic kidney disease, stage III and V lupus nephritis, thrombocytopenia, hemolytic anemia, seizures, alveolar hemorrhage, pulmonary embolism, ascites, splenomegaly, gastrointestinal involvement, complement consumption, higher diagnostic scores (SLICC, ACR/EULAR), higher disease activity (SLEDAI) at onset, and more renal complications. In multivariate analysis, only thrombocytopenia, malar rash, and longer diagnostic delay were independently associated with juvenile-onset SLE.Conclusions The results of this study are consistent with the data in the literature, confirming the severity of juvenile-onset compared to adult-onset SLE.