OBJECTIVES: Lupus is an autoimmune disease that can affect children, with usually an onset during teen years. In children, symptoms are similar to those in adults, but can be more severe and with a greater frequency of renal manifestations. The objective of this study was to describe the characteristics and burden of lupus with child-onset in the hospital in France.

METHODS: A retrospective analysis was conducted using the French national claims hospitals database (PMSI). Eligible pediatric patients (<18 years at first hospitalization for lupus) were included at first hospitalization for lupus (ICD-10 for Systemic Lupus Erythematosus (SLE, ICD-10 M32.X) and/or Lupus Erythematosus (LE, ICD-10 L93.X)) between January 2018 and December 2021 and were followed until last hospitalization or up to December 2022. Burden of disease was evaluated with the number of hospitalizations and average length of stay (aLOS).

RESULTS: 595 patients were identified, including 484 (81.3%) with SLE and 111 (18.7%) with LE. At inclusion, mean age were 13.8 (± 3.3) years with 85.6% of female in SLE patients and 12.2 (± 4.5) years, with 79.3% of females in LE patients. SLE patients presented more severe profile with more comorbidities than LE patients (cardiovascular diseases 17.1% vs 9.9% ; kidney disorders 13.0% vs 9.9% ; metabolic diseases disorders 7.9% vs 3,6% and psychiatric disorder 6.6% vs 0%). Hospital burden was higher in SLE patients with an annual hospitalization rate of 6.4 (±10.3) per patient and an aLOS of 2.2 (±7.0) days vs annual hospitalization rate of 3.9 (±5.0) per patient and an aLOS of 1.9 (±9.2) days in LE patients.

CONCLUSIONS: This study confirms the severity of pediatric lupus, in particular for SLE form that requires early multidisciplinary disease management to minimize associated lifetime burden and morbidity.