Systemic lupus erythematosus (SLE) or just lupus is a disease that causes inflammation and damage to the organs, skin, and joints. The most commonly afflicted organs are the kidneys, heart, lungs, and brain.
Recent data shows that the:
- five-year survival rate of individuals with childhood-onset SLE approaches 100 percent (which means at par with those without lupus), and
- 10-year survival rate is close to 90 percent (which means 9 out of 10 children affected with lupus have survival equal to those without lupus).
The development of progressive organ damage has been documented in 50 to 60 percent of patients.
How serious is lupus?
Infants and adults are affected differently by lupus. Lupus varies in intensity and severity. Lupus symptoms can range from minor to severe, which is more difficult to treat and control.
Many live with lupus, and it is usually not fatal. However, people who experience a significant flare-up are more likely to have life-threatening lupus.
Lupus is a chronic disease; thus, pediatric lupus patients endure unique challenges. For example, the long-term effects of some medications, such as steroids, might be problematic. Lupus is a chronic autoimmune disease that requires the use of immunosuppressants and steroids. Childhood lupus means prolonged exposure to such drugs, thus leading to various other complications.
When does lupus in children usually start?
Lupus is usually diagnosed among children who are 15 years or older, most commonly between the ages of 12 and 14 years. The Arthritis Foundation estimates that about 25,000 children and adolescents have lupus or a similar condition.
- The vast majority of patients with lupus are young women between the ages of 18 and 45 years. This might be because estrogen (a female hormone) appears to be linked to lupus.
- Lupus affects African Americans, Asian Americans, Latinos, and American Indians more than Caucasian Americans.
Neonatal lupus is a disorder in which the newborn obtains Ro/SSA and/or La/SSB antibodies from the mother, which are seen in Sjogren's syndrome. A rash is usually present, but the newborn may also have heart difficulties, liver problems, or low blood levels. The brain is involved only in a few cases. This condition is unrelated to systemic lupus erythematosus and is treated in a completely different manner.
How is childhood lupus different from adult lupus?
Childhood-onset systemic lupus erythematosus (SLE) differs significantly from adult-onset illness, yet therapeutic methods have largely been adopted from the adult domain, according to a pediatric rheumatology expert.
Although adults and infants are affected differently by lupus, there is no particular indication or symptom that is solely found in adults or children. However, there are certain trends seen in children compared with those in adults, which include:
- More rapid onset
- Increased multiorgan involvement
- Hematologic abnormalities are more common
- Neuropsychiatric involvement is more common
- Nearly 80 percent of children developed lupus nephritis within five years of diagnosis
Pediatric lupus nephritis must be identified and treated as soon as possible because if a child with lupus nephritis develops end-stage renal disease, there is a nearly 20 percent higher risk of dying within five years.
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How is lupus diagnosed in children?
Lupus can be difficult to diagnose because its symptoms are similar to those of many other disorders and vary from person to person. Children with lupus are frequently misdiagnosed, which means their disease may go undetected for months or even years. If a child waits for a long period without being diagnosed, they are more likely to develop an organ ailment, making intensive treatment more likely. Children may initially exhibit only one or two symptoms before developing more over time.
The criteria for diagnosing lupus in children are the same as those used for diagnosing lupus in adults. Because lupus is uncommon in children and may mimic so many different diseases, there may be a delay in receiving the correct diagnosis.
According to the American College of Rheumatology, children with lupus may experience one or more of the following symptoms:
- Mouth sores or sores in the nose
- Rash, especially on the cheeks
- Arthritis (inflammation and pain in the joints)
- Unexplained weight loss
Doctors may perform tests to search for other indicators of lupus such as the presence of particular antibodies that are seen in the blood of nearly all patients with lupus, swelling of the tissue lining the lungs or heart, anemia, and abnormal urine tests indicating renal issues. According to the Lupus Foundation of America, two out of every three children or teenagers with lupus develop renal damage.
Other factors that a doctor may evaluate when diagnosing a kid with lupus include:
- Lupus or other autoimmune illnesses run in the family
- The age at which the kid first had lupus symptoms
- How long have the symptoms been present
- What the doctor discovered during a medical exam
What are the treatment options for lupus?
Currently, there is no definitive treatment for lupus. The primary objective of treatment is to alleviate the child's lupus symptoms while also preventing their immune system from attacking key organs.
The type of medicine recommended by the healthcare professional is usually determined by the intensity and type of symptoms the child is experiencing.
Medications used to treat lupus in children include:
Outcome in juvenile onset systemic lupus erythematosus: https://pubmed.ncbi.nlm.nih.gov/16093835/
Pediatric Lupus: https://www.chop.edu/conditions-diseases/pediatric-lupus
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