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Management of dyslipidemia in children and adolescents with systemic lupus erythematosus.

Publication ,  Journal Article
Ardoin, SP; Sandborg, C; Schanberg, LE
Published in: Lupus
2007

Systemic lupus erythematosus (SLE) is an independent risk factor for atherosclerosis, placing children and adolescents with SLE at great risk for developing cardiovascular sequelae, including myocardial infarction, in adulthood. Dyslipidemia and other traditional cardiac risk factors occur frequently in pediatric SLE and are often under-recognized and under-treated. Two dyslipidemia patterns are evident in pediatric SLE. Active disease is characterized by elevated triglycerides (TG) and low high density lipoprotein (HDL). With SLE treatment HDL and TG often normalize, while total cholesterol and low density lipoprotein (LDL) rise. The complex pathophysiology of dyslipidemia in SLE involves cytokines, autoantibodies, disease activity, medications, diet, and physical activity level, as well as other factors. Routine screening for dyslipidemia with fasting lipid profiles is indicated for children and adolescents with SLE. If lipoprotein levels are abnormal, first line therapy involves diet and exercise interventions for a minimum of six months. For persistent dyslipidemia, several pharmacologic therapies are available. Hydroxychloroquine, a common treatment for SLE, can improve lipid profiles and should be considered for all patients with SLE. Statins and bile acid sequestrants are typically added first for dyslipidemia, while niacin and fibrates are reserved for refractory disease and optimally prescribed in a multidisciplinary lipid clinic. Future research is needed to further illuminate the mechanisms of dyslipidemia in pediatric SLE with well designed clinical trials to determine the safest and most effective interventions to correct lipid profiles and prevent atherosclerosis.

Duke Scholars

Published In

Lupus

DOI

ISSN

0961-2033

Publication Date

2007

Volume

16

Issue

8

Start / End Page

618 / 626

Location

England

Related Subject Headings

  • Prevalence
  • Niacin
  • Mass Screening
  • Lupus Erythematosus, Systemic
  • Lipids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hydroxychloroquine
  • Humans
  • Dyslipidemias
  • Complementary Therapies
 

Citation

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ICMJE
MLA
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Ardoin, S. P., Sandborg, C., & Schanberg, L. E. (2007). Management of dyslipidemia in children and adolescents with systemic lupus erythematosus. Lupus, 16(8), 618–626. https://doi.org/10.1177/0961203307079566
Ardoin, S. P., C. Sandborg, and L. E. Schanberg. “Management of dyslipidemia in children and adolescents with systemic lupus erythematosus.Lupus 16, no. 8 (2007): 618–26. https://doi.org/10.1177/0961203307079566.
Ardoin SP, Sandborg C, Schanberg LE. Management of dyslipidemia in children and adolescents with systemic lupus erythematosus. Lupus. 2007;16(8):618–26.
Ardoin, S. P., et al. “Management of dyslipidemia in children and adolescents with systemic lupus erythematosus.Lupus, vol. 16, no. 8, 2007, pp. 618–26. Pubmed, doi:10.1177/0961203307079566.
Ardoin SP, Sandborg C, Schanberg LE. Management of dyslipidemia in children and adolescents with systemic lupus erythematosus. Lupus. 2007;16(8):618–626.
Journal cover image

Published In

Lupus

DOI

ISSN

0961-2033

Publication Date

2007

Volume

16

Issue

8

Start / End Page

618 / 626

Location

England

Related Subject Headings

  • Prevalence
  • Niacin
  • Mass Screening
  • Lupus Erythematosus, Systemic
  • Lipids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hydroxychloroquine
  • Humans
  • Dyslipidemias
  • Complementary Therapies