{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T11:54:46Z","timestamp":1793361286395,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T00:00:00Z","timestamp":1468195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Significant differences have been reported in disease phenotype and severity of systemic lupus erythematosus (SLE) presenting in different age groups. Most indicate a more severe phenotype in juvenile-onset SLE (JSLE). There have been limited studies in older patients and no large studies looking at SLE across all age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We assessed the effect of age of onset of SLE on the clinical phenotype by analysing data from two large UK cohorts (the UK JSLE Cohort and the UCLH SLE cohort).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 924 individuals were compared (413 JSLE, 511 adult-onset SLE). A female preponderance was present, but less pronounced at either end of the age spectrum. Arthritis was more common with advancing age (93% vs 72%, p\u2009&lt;\u20090.001), whereas renal disease (44% vs 33%, p\u2009=\u20090.001), alopecia (47% vs 23%, p\u2009&lt;\u20090.001) and aphthous ulcerations (39% vs 26%, p\u2009=\u20090.001) were more common in the young. Neuropsychiatric lupus was less common in mature-onset SLE ( p\u2009&lt;\u20090.01). JSLE was associated more commonly with thrombocytopenia (21% vs 15%, p\u2009=\u20090.01), haemolytic anaemia (20% vs 3%, p\u2009&lt;\u20090.001), high anti-dsDNA (71% vs 63%, p\u2009=\u20090.009), Sm (22% vs 16%, p\u2009=\u20090.02) and RNP (36% vs 29%, p\u2009&lt;\u20090.04) auto-antibodies. Leucopenia increased with advancing age ( p\u2009&lt;\u20090.001). Mortality has been declining over recent decades. However, death rates were substantially higher than the general population. The standardized mortality ratio was 18.3 in JSLE and 3.1 in adult-onset SLE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These data from the largest-ever direct comparison of JSLE with adult-onset SLE suggest an aggressive phenotype of disease with a worse outcome in patients with JSLE and emphasizes the importance of careful follow-up in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0961203316644333","type":"journal-article","created":{"date-parts":[[2016,5,4]],"date-time":"2016-05-04T20:33:44Z","timestamp":1462394024000},"page":"1542-1550","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":249,"title":["Differences in disease phenotype and severity in SLE across age groups"],"prefix":"10.1177","volume":"25","author":[{"given":"N","family":"Ambrose","sequence":"first","affiliation":[{"name":"Centre for Rheumatology, University College London (UCL) Hospital NHS Foundation Trust, London, UK"},{"name":"Arthritis Research UK Centre for Adolescent Rheumatology, UCL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T A","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology, Alder Hey Children\u2019s NHS Foundation Trust, Liverpool, UK"},{"name":"Department of Women\u2019s and Children\u2019s Health, Institute of Translational Medicine, University of Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Galloway","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology, University College London (UCL) Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Ionnoau","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology, University College London (UCL) Hospital NHS Foundation Trust, London, UK"},{"name":"Arthritis Research UK Centre for Adolescent Rheumatology, UCL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M W","family":"Beresford","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology, Alder Hey Children\u2019s NHS Foundation Trust, Liverpool, UK"},{"name":"Department of Women\u2019s and Children\u2019s Health, Institute of Translational Medicine, University of Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D A","family":"Isenberg","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology, University College London (UCL) Hospital NHS Foundation Trust, London, UK"},{"name":"Arthritis Research UK Centre for Adolescent Rheumatology, UCL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,11]]},"reference":[{"key":"bibr1-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-197103000-00001"},{"key":"bibr2-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780210412"},{"key":"bibr3-0961203316644333","first-page":"319","volume":"74","author":"Worrall JG","year":"1990","journal-title":"Q J Med"},{"key":"bibr4-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313502863"},{"key":"bibr5-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2009.12.012"},{"key":"bibr6-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2010.121"},{"key":"bibr7-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/anr.1780321007"},{"key":"bibr8-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780241002"},{"key":"bibr9-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000147737.57861.7c"},{"key":"bibr10-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.34410"},{"key":"bibr11-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.09.019"},{"key":"bibr12-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307087875"},{"key":"bibr13-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket488"},{"key":"bibr14-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep062"},{"key":"bibr15-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094813"},{"key":"bibr16-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780251101"},{"key":"bibr17-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.34473"},{"key":"bibr18-0961203316644333","doi-asserted-by":"crossref","unstructured":"The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes.\n                      Arthritis Rheum\n                      1999; 42: 599\u2013608.","DOI":"10.1002\/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F"},{"key":"bibr19-0961203316644333","unstructured":"Office for National Statistics. http:\/\/www.ons.gov.uk\/ons (accessed 10 June 2016)."},{"key":"bibr20-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780360310"},{"key":"bibr21-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.23204"},{"key":"bibr22-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1191\/096120399678847786"},{"key":"bibr23-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1136\/ard.57.8.456"},{"key":"bibr24-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311416694"},{"key":"bibr25-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.050070"},{"key":"bibr26-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1002\/art.34410"},{"key":"bibr27-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1542\/peds.83.2.235"},{"key":"bibr28-0961203316644333","first-page":"182","volume":"14","author":"Maddison PJ","year":"1987","journal-title":"J Rheumatol Suppl"},{"key":"bibr29-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1136\/ard.50.10.702"},{"key":"bibr30-0961203316644333","first-page":"175","volume":"11","author":"Catoggio LJ","year":"1984","journal-title":"J Rheumatol"},{"key":"bibr31-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307088006"},{"key":"bibr32-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.141697"},{"key":"bibr33-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1177\/0961203312443421"},{"key":"bibr34-0961203316644333","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/34.9.866"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203316644333","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0961203316644333","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203316644333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:17:01Z","timestamp":1777677421000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0961203316644333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,11]]},"references-count":34,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2016,12]]}},"alternative-id":["10.1177\/0961203316644333"],"URL":"https:\/\/doi.org\/10.1177\/0961203316644333","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,11]]}}}