Exploring gastrointestinal manifestations in childhood onset systemic lupus erythematosus - Insights from a multicenter study

• Published in: Lupus Vol. 33; no. 12; pp. 1358 - 1364
• Main Authors: Sönmez, Hafize Emine, Batu, Ezgi Deniz, İşgüder, Rana, Şahin, Nihal, Aliyev, Emil, Aslan, Esma, Çoban, Sümeyra, Güngörer, Vildan, Karadağ, Şerife Gül, Karaçayır, Nihal, Kısaoğlu, Hakan, Yekedüz Bülbül, Aydan, Garip, Sevinç, Karalı, Yasin, Ayduran, Semra, Demir, Selcan, Kaya Akça, Ümmüşen, Başaran, Özge, Şahin, Sezgin, Kasap, Belde, Kilic, Sara Sebnem, Kışla Ekinci, Rabia Miray, Kısaarslan, Ayşenur Paç, Kalyoncu, Mukaddes, Bakkaloğlu, Sevcan, Yüksel, Selçuk, Aktay Ayaz, Nuray, Çelikel Acar, Banu, Sözeri, Betül, Kasapçopur, Özgür, Ünsal, Erbil, Özen, Seza
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-10-2024; Sage Publications Ltd
• Subjects: Adverse events; Children; Comorbidity; Diarrhea; Differential diagnosis; Gastrointestinal tract; Jaundice; Liver; Lupus; Pediatrics; Rheumatology; Systemic lupus erythematosus; gastrointestinal system; Systemic lupus erythematosus; autoimmune hepatitis; child
• ISSN: 0961-2033; 1477-0962; 1477-0962
• DOI: 10.1177/09612033241279071

Objective
Systemic lupus erythematosus (SLE) constitutes an autoimmune disorder with potential involvement of the gastrointestinal system (GIS). Our objective was to assess the gastrointestinal (GI) manifestations in patients diagnosed with childhood onset SLE.
Methods
The study cohort consisted of 123 patients with childhood onset-SLE and GIS involvement from 16 referral departments of pediatric rheumatology. All participants met the Systemic Lupus International Collaborating Clinics criteria.
Results
Out of 123 patients, 78 (63.4%) exhibited GIS involvement at the initial SLE diagnosis, whereas the remaining 45 (36.6%) developed GI symptoms after a median duration of 12 (3–140) months. Eighty-two (66.7%) individuals experienced symptoms related to the GI tract, whereas the remaining patients received a diagnosis of GI involvement through laboratory assessments. The predominant initial GIS involvement symptom was abdominal pain, observed in 77 (62.6%) patients, followed by elevated hepatic transaminases in 70 (56.9%), hepatomegaly in 40 (32.5%), diarrhea in 26 (21.1%), and jaundice in 11 (8.9%) patients. The GIS involvement was associated with SLE in 82 (78.6%), while it resulted from drug-related adverse events in 35 (28.5%) patients or comorbidities in 6 (0.5%) patients.
Conclusion
GIS involvement should be considered in all childhood onset-SLE patients, especially in the presence of suggestive symptoms or elevated hepatic transaminases. It is also crucial to consider SLE in the differential diagnosis of GIS manifestations in children. Apart from GIS involvement directly associated with SLE, adverse events of drugs should be kept in mind.