PReS-FINAL-2297: Atmospheric pollution: influence on disease activity in childhood-onset systemic lupus erythematosus patients

Methods This was a longitudinal panel study including 410 consecutive medical visits in 22 C-SLE patients (ACR criteria). They were followed at the Pediatric Rheumatology Unit, Children’s Institute, Faculdade de Medicina da Universidade de Sao Paulo, Brazil, between 2005 and 2010. Disease activity was evaluated according to Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and the patients were divided arbitrarily in two groups: with disease activity (SLEDAI>8) and without disease activity (SLEDAI<8). The São Paulo State Environmental Agency (CETESB) provided daily concentrations of inhaled particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO). Meteorological variables, such as the minimum temperature and relative humidity, were obtained from the Institute of Astronomy and Geophysics of the University of São Paulo. Generalized estimation equation (GEE) model were used for binomial distribution to assess the impact of these measurements in the SLEDAI 2K score, considering the fixed effects for repetitive measurements, and adjusted for erythrocyte sedimentation rate, C-reactive protein, prednisone and/or immunosuppressant use, presence of infection 20 days before the medical appointment, minimum temperature and relative humidity. The results were expressed in relative risk (RR) and confidence interval (CI) of 95%.