SLICC-based Phenotype of Juvenile Systemic Lupus Erythematosus in the Philippines

Abstract

Objective. To describe the clinical profile of Filipino pediatric SLE patients as determined using the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria.

Methods. We checked which among the SLICC criteria were fulfilled by Filipino pediatric SLE patients when we
examined them and their case records, as part of a nationwide genetic study on SLE conducted from October
2015 to March 2017.

Results. Ninety-seven (out of 321) who were diagnosed to have SLE before 19 years of age were evaluated.
The mean age of the population at the time of evaluation was 19.8 ± 6.9 years. Females comprised 94% of our
population. Mean age of onset was 14.4 ± 2.7 years, while the mean age of diagnosis was at 14.5 ± 2.6 years. Acute cutaneous rash was found in 87%; oral ulcers 65%; renal disorder 63%; non-scarring alopecia 61%; arthritis 58%; chronic cutaneous rash 36%; leukopenia 35%; hemolytic anemia 34%; serositis 25%; thrombocytopenia 23%, and neurologic disorder 8%. Anti-nuclear antibody was present in 85%; low complement 32%; anti-dsDNA 28%; direct Coombs’ 16%; antiphospholipid antibody 3%; and anti-Smith antibody 1%. Kidney biopsy was performed in only 14% (14/97) of patients, of whom 27% had class III histopathologic characteristic.

Conclusions. Filipino pediatric SLE patients typically present with mucocutaneous, renal, and musculoskeletal
involvement. Cardiopulmonary and neurologic manifestations are found to be less common among them. Finally, renal biopsy is not commonly performed among these patients.