Lupus in Children
The following describes the symptoms, diagnosis and treatment of lupus. For specific information regarding your child's health and treatment options, please contact your child's Hurley physician or medical professional.
What is lupus?
Systemic lupus erythematosus, also known as SLE or lupus, is a disease that may show a variety of symptoms such as periodic episodes of inflammation of the joints, tendons, other connective tissues, and organs, including the heart, lungs, blood vessels, brain, kidneys and skin. The heart, lungs, kidneys, and brain are the organs most affected. Left untreated, these symptoms can cause permanent or widespread damage to the body.
Lupus affects each person differently and the effects of the illness range from mild to severe. In some cases, lupus can be fatal. The disease is known to have periods of flare-ups and periods of remission (partial or complete lack of symptoms). Females are affected with lupus three to ten times more often than males. Young to middle-aged women (late teens to 45) are the largest group affected by lupus. This may be due to the fact that estrogen (a female hormone) seems to be associated with lupus. Lupus also affects more African-Americans, Asian Americans, Latinos, and Native Americans than Caucasian Americans.
Lupus in children
Lupus in children occurs most often at the age of 15 and older. According to the Arthritis Foundation, about 25,000 children and adolescents have lupus or a related disorder. Children with lupus can have a large degree of kidney involvement. The severity of the kidney involvement can alter the survival rate of patients with lupus. In some cases, kidney damage is so severe it leads to kidney failure.
What causes lupus?
Lupus is an autoimmune disorder, which means the body's immune system attacks its own healthy cells and tissues, and can have many factors that cause it. These factors often include both genetic and environmental circumstances, where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition. Often one gender (either males or females) is affected more frequently than the other in such conditions, and several family members may also be affected because lupus is partly caused by genes.
What are the symptoms of lupus?
The symptoms of lupus may resemble other medical conditions or problems. Always consult your Hurley physician for a diagnosis. The American College of Rheumatology has created a set of criteria to help physicians diagnose lupus, listing the following as the most common symptoms:
- Malar rash: a rash shaped like a butterfly that is usually found on the bridge of the nose and the cheeks
- Discoid rash: a raised rash found on the head, arms, chest, or back
- Inflammation of the joints
- Sensitivity to sunlight
- Hair loss
- Mouth ulcers
- Fluid around the lungs, heart or other organs
- Kidney problems
- Low white blood cell or low platelet count
- Raynaud's phenomenon: a condition in which the blood vessels of the fingers and toes go into spasm when triggered by factors such as cold, stress or illness
- Weight loss
- Nerve or brain dysfunction
How is lupus diagnosed?
Lupus can be difficult to diagnose because symptoms may be vague or experienced as somewhat mild at certain times. There is no single test that can diagnose lupus. A diagnosis is usually confirmed based on a complete medical history, reported symptoms and a physical examination that may include the following:
- Blood tests to detect for certain antibodies that are present in most people with lupus
- Blood and urine tests to assess kidney function
- Complement test to measure the level of complement (a group of proteins in the blood that help destroy foreign substances). Low levels of complement in the blood are often associated with lupus
- X-ray - a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs
- Erythrocyte sedimentation rate - a measurement of potential inflammation based on how quickly red blood cells fall to the bottom of a test tube
- C-reactive protein (CRP) testing - another tool that can identify potential inflammation through the presence of elevated levels of a specific protein
How is lupus treated?
Lupus is treatable but not curable. Specific treatment for lupus will be determined by your Hurley physician based on the following:
- Your age, overall health, and medical history
- Extent of the condition
- Your tolerance for specific medications, procedures and therapies
- Expectation for the course of the disease
- Specific organs that are affected
- Your opinion or preference
If lupus symptoms are mild, treatment may not be necessary, other than possibly nonsteroidal anti-inflammatory medications (NSAIDs) for joint pain. Other treatment may include:
- Hydroxychloroquine, chloroquine or a combination of these medications
- Corticosteroids (to control inflammation)
- Immunosuppressive medication (to suppress the body's autoimmune system)
- Liberal use of sunscreen and decreased time outdoors. Approximately one-third of persons with lupus have the tendency to develop a rash in the sun.
- Rest, including at least 8 to 10 hours of sleep at night and naps and breaks during the day
- Stress reduction
- Well-balanced diet
- Immediate treatment of infections
Children with lupus should not receive immunizations with live viruses, including chickenpox, MMR (measles, mumps, rubella) and oral polio vaccines. Consult your child's Hurley physician regarding all vaccines.