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Volume 49, Number 2, April 2016

Comorbidities of pediatric systemic lupus erythematosus: A 6-year nationwide population-based study

Pei-Chun Chan, Chong-Hua Yu, Kuo-Wei Yeh, Jorng-Tzong Horng, Jing-Long Huang


Corresponding author:

Corresponding author. Jing-Long Huang, Division of Pediatric Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Hsin Street, Kweishan, Taoyuan, Taiwan. 


Background and purpose: 

Systemic lupus erythematous (SLE) is a systemic and complex disease that can involve multiple organs. To clarify the risk of developing associated comorbidities after a diagnosis of SLE in children, we used the National Health Insurance Research Database (NHIRD) in Taiwan to investigate diseases experienced in these patients. This is the first nationwide population-based study of the comorbidities of pediatric SLE patients. 



The study was based on data from the NHIRD in Taiwan. Children were enrolled who were below the age of 18 years and whose disease corresponded to the International Classification of Disease, Ninth Revision Clinical Modification (ICD-9-CM) diagnostic code of 710.0 (SLE). The comorbidities associated with SLE were defined by the ICD-9-CM codes of diseases that presented after the SLE diagnosis. We analyzed the common diseases in SLE patients and compared the frequency of these diseases between pediatric SLE patients and the non-SLE population.



From January 1, 2003 to December 31, 2008, we enrolled 904 SLE patients (774 females, 130 males). Infection (86.36%) was the most common comorbidity in pediatric SLE. Other comorbidities were musculoskeletal diseases (16.7%), cardiovascular diseases (16.37%), ocular diseases (10.73%), and renal diseases (6.75%). Children with SLE had a higher risk of heart failure, hypertension, osteoporosis, cataracts, glaucoma, dyslipidemia, seizures, encephalopathy, and malignant changes, compared to non-SLE populations. 



The population-based cohort demonstrated several systemic and/or chronic diseases in pediatric SLE patients in Taiwan. Children with SLE were more susceptible to these diseases, including malignancy, compared to the non-SLE population. 


Key words:

Comorbidity, Pediatric, Systemic lupus erythematosus, Taiwan