Alcohol, smoking and illicit drug use in pediatric systemic lupus erythematosus patients.

OBJECTIVE: to evaluate alcohol, smoking and/or illicit drug use, and history of bullying in adolescent childhood-onset systemic lupus erythematosus (c-SLE) and healthy controls.

METHODS: 174 adolescents with pediatric rheumatic diseases were selected. All of the 34 c-SLE patients and 35 healthy controls participated in this study. A cross-sectional study included demographic/anthropometric data and puberty markers assessments; structured questionnaire and CRAFFT screening interview.

RESULTS: McNemar tests indicated an excellent test-retest reliability of the structured questionnaire (p=1.0). The median current age was similar between c-SLE patients and controls [15 (12-18) vs. 15(12-18) years, p=0.563]. The median of menarche age was significantly higher in c-SLE patients compared to controls [12 (10-15) vs. 11.5 (9-15) years, p=0.041], particularly in those that lupus had occurred before first menstruation [13 (12-15) vs. 11.5 (9-15) years, p=0.007]. The other puberty marker and sexual function parameters were similar in both groups (p>0.05). Alcohol use was similar in both c-SLE patients and controls (38% vs. 46%, p=0.628). A trend of lower frequency of Crafft score ≥ 2 (high risk for substance abuse/dependence) was evidenced in c-SLE patients compared to controls (0% vs. 15%, p=0.053). Bullying was reported similarly for the two groups (43% vs. 44%, p=0.950). Further analysis in lupus patients regarding alcohol/smoking/illicit drug use showed no differences in demographic data, puberty markers, history of bullying, sexual function, contraceptive use, disease activity/damage scores, clinical/laboratorial features and treatments (p>0.05).

CONCLUSION: This study showed high frequencies of early alcohol use in lupus adolescents and healthy controls, despite of a possible low risk for substance abuse/dependence in c-SLE patients.