{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:48:00Z","timestamp":1785422880568,"version":"3.56.0"},"reference-count":133,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hugh Greenwood Legacy Fund"},{"name":"Faculty of Health and Life Sciences, University of Liverpool"},{"id":[{"id":"https:\/\/ror.org\/04xs57h96","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Patients with childhood-onset rheumatic diseases may be at additional risk of developing other health conditions. This systematic review aimed to (i) identify and describe the comorbidities associated with three significant childhood-onset rheumatic diseases\u2014Juvenile Idiopathic Arthritis (JIA), Juvenile-onset Systemic Lupus Erythematosus (jSLE), and Juvenile Dermatomyositis (JDM); (ii) describe comorbidity prevalence and incidence reported as apparent in childhood or adulthood, and (iii) compare these comorbidity estimates with control groups. Methods: PubMed, Web of Science, and Scopus databases were systematically searched without restrictions, in accordance with PRISMA guidelines. Where three or more studies reported the same comorbidity, a meta-analysis was performed using random-effect models. The risk of bias and study quality were assessed using an adjusted version of the Newcastle\u2013Ottawa Scale. Results: Comorbidities were reported in 136,072 patients, of which 115,062 (84.56%) presented in childhood. There was significant heterogeneity within the results. The comorbidities presenting in childhood were uveitis (13.95%, 95% CI 11.79\u201316.43) in JIA patients, chronic kidney disease (48.38%, 95% CI 0.67\u201399.24) in jSLE patients, and calcinosis (29.70%, 95% CI 25.91\u201333.81) in JDM patients. The comorbidities identified in adult populations with childhood-onset rheumatic disease were uveitis (14.46%, 95% CI9.76\u201320.90) in JIA, hypertension (18.30%, 95% CI 7.52\u201338.16) in jSLE, and calcinosis (40.37%, 19.02\u201366.11) in JDM patients. Almost all comorbidities that were compared to control groups were more common in patients with childhood-onset rheumatic disease if statistically significant. Conclusions: Uveitis, chronic kidney disease\/hypertension and calcinosis were most commonly identified among JIA, jSLE and JDM patients, respectively. Patients with the three childhood-onset rheumatic diseases evaluated in this systematic review were often found to be at higher risk of comorbidities compared to controls. This finding supports the need for the proactive, multidisciplinary management of comorbidities by clinicians and highlights the breadth of disease burden for patients.<\/jats:p>","DOI":"10.3390\/children13080995","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T08:52:01Z","timestamp":1785228721000},"page":"995","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comorbidities in Juvenile-Onset Rheumatic Diseases: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8697-1833","authenticated-orcid":false,"given":"Sab","family":"Siddiq","sequence":"first","affiliation":[{"name":"Department of Health Data Science, Institute of Population Health, University of Liverpool, Waterhouse Building, Block F, 1\u20135 Brownlow Street, Liverpool L69 3GL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1621-3521","authenticated-orcid":false,"given":"Shabnam","family":"Cheetham","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology, Royal Manchester Children\u2019s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4965-3259","authenticated-orcid":false,"given":"Clare E.","family":"Pain","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology, Institute in the Park, Alder Hey Children\u2019s NHS Foundation Trust, Liverpool L14 5AB, UK"},{"name":"Department of Women and Children\u2019s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L8 7SS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve M. D.","family":"Smith","sequence":"additional","affiliation":[{"name":"School of Infection and Immunity, University of Glasgow, Glasgow G12 8TA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sizheng Steven","family":"Zhao","sequence":"additional","affiliation":[{"name":"Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Musculoskeletal & Dermatological Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK"},{"name":"NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester M13 9WU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza J.","family":"McCann","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology, Institute in the Park, Alder Hey Children\u2019s NHS Foundation Trust, Liverpool L14 5AB, UK"},{"name":"Department of Women and Children\u2019s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L8 7SS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Health Data Science, Institute of Population Health, University of Liverpool, Waterhouse Building, Block F, 1\u20135 Brownlow Street, Liverpool L69 3GL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1002\/1529-0131(200003)43:3<541::AID-ANR9>3.0.CO;2-T","article-title":"Medium- and long-term functional outcomes in a multicenter cohort of children with juvenile dermatomyositis","volume":"43","author":"Huber","year":"2000","journal-title":"Arthritis Rheum."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1002\/acr.20015","article-title":"Long-term outcome and prognostic factors of juvenile dermatomyositis: A multinational, multicenter study of 490 patients","volume":"62","author":"Ravelli","year":"2010","journal-title":"Arthritis Care Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"237","DOI":"10.2147\/OARRR.S174408","article-title":"Depression and Anxiety in Patients with Juvenile Idiopathic Arthritis: Current Insights and Impact on Quality of Life, A Systematic Review","volume":"11","author":"Fair","year":"2019","journal-title":"Open Access Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1002\/art.40697","article-title":"Long-Term Clinical Outcomes in a Cohort of Adults with Childhood-Onset Systemic Lupus Erythematosus","volume":"71","author":"Groot","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.semarthrit.2019.06.014","article-title":"Long-term outcomes in Juvenile Myositis patients","volume":"50","author":"Tsaltskan","year":"2020","journal-title":"Semin. 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