Childhood SLE May Be Linked to Eye Conditions That Cause Blindness, Study Finds

Childhood-onset systemic lupus erythematosus (cSLE) may be linked to the development of eye problems such as uveitis that can cause blindness, a study says.

The research, “Uveitis In Childhood-Onset Systemic Lupus Erythematosus Patients: A Multicenter Survey,” was published in the journal Clinical Rheumatology.

Nearly a third of SLE patients develop complications that can affect several eye structures, including the retina, optic nerve and uvea, or middle layer of the eye that includes the iris. Inflammation of the uvea, a condition known as uveitis, may lead to blindness.

Uveitis is rare among SLE patients, but some patients have developed it and become blind.

Looking for a link between cSLE and uveitis, Brazilian researchers analyzed the medical records of 852 patients at 10 pediatric-rheumatology centers in São Paulo. All had developed SLE before they were 18, and all were 25 or younger at the time of the study.

The research team analyzed both SLE and uveitis records.

Only seven of the 852 cSLE patients — or 0.8 percent — had been diagnosed with uveitis. One had developed a cataract and irreversible blindness and another blindness in one eye.

Six of the seven were diagnosed with uveitis within six months of being diagnosed with cSLE, an indication that uveitis appeared early in cSLE.

Researchers also found that the seven uveitis patients had higher SLE disease activity than patients without uveitis.

Uveitis patients had much higher rates of certain health issues than those without uveitis: fever (71% vs. 12%), lymphadenopathy (29% vs. 1.4%), arthritis (43% vs. 7%), and use of intravenous methylprednisolone (71% vs. 22%). Lymphadenopathy is a disease of the lymph nodes. Methylprednisolone is an immune-system-suppression and anti-inflammation therapy.

Further analysis indicated that fever was significantly associated with uveitis, independent of apparent disease activity or methylprednisolone use.

“Uveitis prevalence in Brazilian cSLE patients was 0.8%, which confirms that uveitis is a rare manifestation in children and adolescents with SLE,” wrote the researchers, adding that “early recognition is essential due to the possibility of irreversible blindness.”