Background and Aims We aimed to assess the influence of co-existing atopy on the prognosis of juvenile systemic lupus erythematosus (JSLE)

Methods Patients diagnosed with JSLE between October 2005 and April 2016 were enrolled in a prospective cohort study and followed for 2 years. Management of patients was evaluated using SLEDAI-2K score. Eighty JSLE patients were enrolled at diagnosis and were divided into those with atopy and those without.

Results Atopic patients had significantly higher SLEDAI-2K at disease onset (16.09 vs . 11.18), higher anti-double-stranded DNA (66.58 vs . 44.55 IU/ml), higher erythrocyte sedimentation rate (52.89 vs . 38.27 mm/h), higher percentage of total B-cells (25.85 vs . 19.51%), lower percentage (7.26 vs . 9.03%) and activity (9.92 vs . 11.32%) of natural killer cells, lower complement C3 (0.51 vs . 0.69g/L), and lower complement C4 (0.06 vs . 0.12g/L) (p<0.05 for all comparisons). At 1 month, 3, 6, 12, 18 and 24 months, JSLE patients with atopy reached higher SLEDAI-2K and lower ΔSLEDAI-2K improvement rate (at 1 month, 8.34 vs. 4.71 and 43.63 vs. 57.95%, respectively; at 3 months, 8.57 vs. 2.62 and 48.39 vs. 75.10%, respectively; at 6 months, 6.91 vs. 2.38 and 53.59 vs. 77.26%, respectively; at 12 months, 4.71 vs. 1.80 and 69.54 vs. 84.10%, respectively; at 18 months, 4.66 vs. 2.02 and 68.14 vs. 82.93%, respectively; at 24 months, 8.57 vs. 2.62 and 70.00 vs. 81.88%, respectively; all p<0.05).

Conclusions Co-existing atopy in children with JSLE may exert an adverse influence on JSLE, with atopic patients manifesting more severe disease at diagnosis and poorer outcome.