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Bone mineral density in juvenile onset systemic lupus erythematosus. OBJECTIVE: To compare bone mineral density in patients with juvenile-onset Systemic lupus erythematosus and healthy controls. PARTICIPANTS: Serial bone mineral density measurements in 27 patients with juvenile-onset systemic lupus were compared to 97 healthy age-matched controls. RESULTS: All patients with juvenile-onset had low bone mineral density scores at initial assessment that progressed over disease course. Low body mass index was independently associated with a decline in bone mineral density Z scores; disease activity, use of immunosuppressive agents and vitamin D levels were not risk factors. CONCLUSIONS: Patients with juvenile-onset systemic lupus erythematosus have low bone mineral density.