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<article article-type="research-article" dtd-version="1.1" xml:lang="en" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><front><journal-meta><journal-id journal-id-type="publisher-id">LUP</journal-id><journal-title-group><journal-title>Lupus</journal-title></journal-title-group><issn pub-type="ppub">0961-2033</issn><issn pub-type="epub">1477-0962</issn><publisher><publisher-name>SAGE Publications</publisher-name><publisher-loc>Sage UK: London, England</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/0961203320984251</article-id><article-id pub-id-type="publisher-id">10.1177_0961203320984251</article-id><article-categories><subj-group subj-group-type="heading"><subject>Papers</subject></subj-group></article-categories><title-group><article-title>Clinical and laboratory phenotypes in juvenile-onset Systemic Lupus Erythematosus across ethnicities in the UK</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Massias</surname><given-names>Joseph S</given-names></name><xref ref-type="aff" rid="aff1-0961203320984251">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8371-7597</contrib-id><name><surname>Smith</surname><given-names>Eve MD</given-names></name><xref ref-type="aff" rid="aff2-0961203320984251">2</xref><xref ref-type="aff" rid="aff3-0961203320984251">3</xref></contrib><contrib contrib-type="author"><name><surname>Al-Abadi</surname><given-names>Eslam</given-names></name><xref ref-type="aff" rid="aff4-0961203320984251">4</xref></contrib><contrib contrib-type="author"><name><surname>Armon</surname><given-names>Kate</given-names></name><xref ref-type="aff" rid="aff5-0961203320984251">5</xref></contrib><contrib contrib-type="author"><name><surname>Bailey</surname><given-names>Kathryn</given-names></name><xref ref-type="aff" rid="aff6-0961203320984251">6</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8911-4113</contrib-id><name><surname>Ciurtin</surname><given-names>Coziana</given-names></name><xref ref-type="aff" rid="aff7-0961203320984251">7</xref></contrib><contrib contrib-type="author"><name><surname>Davidson</surname><given-names>Joyce</given-names></name><xref ref-type="aff" rid="aff8-0961203320984251">8</xref></contrib><contrib contrib-type="author"><name><surname>Gardner-Medwin</surname><given-names>Janet</given-names></name><xref ref-type="aff" rid="aff9-0961203320984251">9</xref></contrib><contrib contrib-type="author"><name><surname>Haslam</surname><given-names>Kirsty</given-names></name><xref ref-type="aff" rid="aff10-0961203320984251">10</xref></contrib><contrib contrib-type="author"><name><surname>Hawley</surname><given-names>Dan P</given-names></name><xref ref-type="aff" rid="aff11-0961203320984251">11</xref></contrib><contrib contrib-type="author"><name><surname>Leahy</surname><given-names>Alice</given-names></name><xref ref-type="aff" rid="aff12-0961203320984251">12</xref></contrib><contrib contrib-type="author"><name><surname>Leone</surname><given-names>Valentina</given-names></name><xref ref-type="aff" rid="aff13-0961203320984251">13</xref></contrib><contrib contrib-type="author"><name><surname>McErlane</surname><given-names>Flora</given-names></name><xref ref-type="aff" rid="aff14-0961203320984251">14</xref></contrib><contrib contrib-type="author"><name><surname>Mewar</surname><given-names>Devesh</given-names></name><xref ref-type="aff" rid="aff15-0961203320984251">15</xref></contrib><contrib contrib-type="author"><name><surname>Modgil</surname><given-names>Gita</given-names></name><xref ref-type="aff" rid="aff16-0961203320984251">16</xref></contrib><contrib contrib-type="author"><name><surname>Moots</surname><given-names>Robert</given-names></name><xref ref-type="aff" rid="aff17-0961203320984251">17</xref></contrib><contrib contrib-type="author"><name><surname>Pilkington</surname><given-names>Clarissa</given-names></name><xref ref-type="aff" rid="aff18-0961203320984251">18</xref></contrib><contrib contrib-type="author"><name><surname>Ramanan</surname><given-names>Athimalaipet V</given-names></name><xref ref-type="aff" rid="aff19-0961203320984251">19</xref></contrib><contrib contrib-type="author"><name><surname>Rangaraj</surname><given-names>Satyapal</given-names></name><xref ref-type="aff" rid="aff20-0961203320984251">20</xref></contrib><contrib contrib-type="author"><name><surname>Riley</surname><given-names>Phil</given-names></name><xref ref-type="aff" rid="aff21-0961203320984251">21</xref></contrib><contrib contrib-type="author"><name><surname>Sridhar</surname><given-names>Arani</given-names></name><xref ref-type="aff" rid="aff22-0961203320984251">22</xref></contrib><contrib contrib-type="author"><name><surname>Wilkinson</surname><given-names>Nick</given-names></name><xref ref-type="aff" rid="aff23-0961203320984251">23</xref></contrib><contrib contrib-type="author"><name><surname>Beresford</surname><given-names>Michael W</given-names></name><xref ref-type="aff" rid="aff2-0961203320984251">2</xref><xref ref-type="aff" rid="aff3-0961203320984251">3</xref></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1295-6179</contrib-id><name><surname>Hedrich</surname><given-names>Christian M</given-names></name><xref ref-type="corresp" rid="corresp1-0961203320984251"/><xref ref-type="aff" rid="aff2-0961203320984251">2</xref><xref ref-type="aff" rid="aff3-0961203320984251">3</xref></contrib><on-behalf-of>on behalf of the UK JSLE  Study Group</on-behalf-of></contrib-group><aff id="aff1-0961203320984251"><label>1</label>School of Medicine, University of Liverpool, Liverpool, UK</aff><aff id="aff2-0961203320984251"><label>2</label>Department of Women's &amp; Children’s Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK</aff><aff id="aff3-0961203320984251"><label>3</label>Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust Hospital, Liverpool, UK</aff><aff id="aff4-0961203320984251"><label>4</label>Department of Rheumatology, Birmingham Children’s Hospital, Birmingham, UK</aff><aff id="aff5-0961203320984251"><label>5</label>Department of Paediatric Rheumatology, Cambridge University Hospitals, Cambridge, UK</aff><aff id="aff6-0961203320984251"><label>6</label>Department of Paediatric Rheumatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK</aff><aff id="aff7-0961203320984251"><label>7</label>Centre for Adolescent Rheumatology, University College London, London, UK</aff><aff id="aff8-0961203320984251"><label>8</label>Department of Paediatric Rheumatology, Royal Hospital for Sick Children, Edinburgh, UK</aff><aff id="aff9-0961203320984251"><label>9</label>Department of Child Health, University of Glasgow, Glasgow, UK</aff><aff id="aff10-0961203320984251"><label>10</label>Department of Paediatrics, Bradford Royal Infirmary, Bradford, UK</aff><aff id="aff11-0961203320984251"><label>11</label>Department of Paediatric Rheumatology, Sheffield Children’s Hospital, Sheffield, UK</aff><aff id="aff12-0961203320984251"><label>12</label>Department of Paediatric Rheumatology, Southampton General Hospital, Southampton, UK</aff><aff id="aff13-0961203320984251"><label>13</label>Department of Paediatric Rheumatology, Leeds Children Hospital, Leeds, UK</aff><aff id="aff14-0961203320984251"><label>14</label>Paediatric Rheumatology, Great North Children’s Hospital, Royal Victoria Infirmary, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK</aff><aff id="aff15-0961203320984251"><label>15</label>Department of Rheumatology, Royal Liverpool University Hospital, Liverpool, UK</aff><aff id="aff16-0961203320984251"><label>16</label>Department of Paediatrics, Musgrove Park Hospital, Taunton, UK</aff><aff id="aff17-0961203320984251"><label>17</label>Department of Rheumatology, University Hospital Aintree, Liverpool, UK</aff><aff id="aff18-0961203320984251"><label>18</label>Department of Paediatric Rheumatology, Great Ormond Street Hospital, London, UK</aff><aff id="aff19-0961203320984251"><label>19</label>University Hospitals Bristol NHS Foundation Trust &amp; Bristol Medical School, University of Bristol, Bristol, UK</aff><aff id="aff20-0961203320984251"><label>20</label>Department of Paediatric Rheumatology, Nottingham University Hospitals, Nottingham, UK</aff><aff id="aff21-0961203320984251"><label>21</label>Department of Paediatric Rheumatology, Royal Manchester Children’s Hospital, Manchester, UK</aff><aff id="aff22-0961203320984251"><label>22</label>Department of Paediatrics, Leicester Royal Infirmary, Leicester, UK</aff><aff id="aff23-0961203320984251"><label>23</label>Guy's &amp; St Thomas's NHS Foundation Trust, Evelina Children's Hospital, London, UK</aff><author-notes><fn fn-type="equal" id="fn1-0961203320984251"><p>The first two authors are joint first authors.</p></fn><corresp id="corresp1-0961203320984251">Christian M Hedrich, Institute in the Park, Alder Hey Children's Hospital, Eaton Road, Liverpool L12 2AP, UK. Email: <email>chedrich@liverpool.ac.uk</email></corresp></author-notes><pub-date pub-type="epub"><day>7</day><month>1</month><year>2021</year></pub-date><volume>30</volume><issue>4</issue><fpage>597</fpage><lpage>607</lpage><history><date date-type="received"><day>28</day><month>9</month><year>2020</year></date><date date-type="accepted"><day>8</day><month>12</month><year>2020</year></date></history><permissions><copyright-statement>© The Author(s) 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder content-type="sage">SAGE Publications</copyright-holder><license><ali:license_ref start_date="2021-01-07" xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc/4.0/</ali:license_ref><license-p>This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc/4.0/">https://creativecommons.org/licenses/by-nc/4.0/</ext-link>) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (<ext-link ext-link-type="uri" xlink:href="https://us.sagepub.com/en-us/nam/open-access-at-sage">https://us.sagepub.com/en-us/nam/open-access-at-sage</ext-link>).</license-p></license></permissions><abstract><p>Systemic lupus erythematosus (SLE) is a systemic autoimmune/inflammatory disease. Patients diagnosed with juvenile-onset SLE (jSLE), when compared to individuals with adult-onset SLE, develop more severe organ involvement, increased disease activity and greater tissue and organ damage. In adult-onset SLE, clinical characteristics, pathomechanisms, disease progression and outcomes do not only vary between individuals and age groups, but also ethnicities. However, in children and young people, the influence of ethnicity on disease onset, phenotype and outcome has not been investigated in detail. In this study, we investigated clinical and laboratory characteristics in pediatric SLE patients from different ethnic backgrounds (White Caucasian, Asian, Black African/Caribbean) accessing data from a national cohort of jSLE patients (the UK JSLE Cohort Study). Among jSLE patients in the UK, ethnicity affects both the disease’s clinical course and outcomes. At diagnosis, Black African/Caribbean jSLE patients show more “classical” laboratory and clinical features when compared to White Caucasian or Asian patients. Black African/Caribbean jSLE patients exhibit more renal involvement and more frequently receive cyclophosphamide and rituximab. Studies targeting ethnicity-specific contributors to disease expression and phenotypes are necessary to improve our pathophysiological understanding, diagnosis and treatment of jSLE.</p></abstract><kwd-group><kwd>jSLE</kwd><kwd>lupus</kwd><kwd>ethicity</kwd><kwd>phenotype</kwd><kwd>paediatric</kwd></kwd-group><funding-group specific-use="FundRef"><award-group id="award1-0961203320984251"><funding-source id="funding1-0961203320984251"><institution-wrap><institution>LUPUS UK</institution></institution-wrap></funding-source></award-group></funding-group><custom-meta-group><custom-meta><meta-name>typesetter</meta-name><meta-value>ts2</meta-value></custom-meta></custom-meta-group></article-meta></front></article>