Lupus in Children and Adolescents

Lupus in Children: It is estimated that over 1.5 million Americans are diagnosed with systemic Lupus. Of that 1.5 million, 20 percent are children or adolescents. When Lupus strikes children and adolescents they usually experience a more serious course.

Lupus in Children: Systemic Lupus Erythematosus ("lupus") is a chronic, autoimmune disease that affects many parts of the body. It is estimated that over 1.5 million Americans have lupus. Approximately 15- 20 percent of all cases of lupus are diagnosed before the age of 16 years. Compared with adult-onset lupus, childhood-onset lupus tends to be more active at diagnosis and follow up, involve the kidneys and require more aggressive therapy.

The symptoms of lupus are often vague, consisting of fatigue, rashes, fever, hair loss, mouth ulcers and pain or swelling of the joints. These symptoms may go on for several months before the diagnosis is made.

As recently as 40 years ago, the prognosis and survival rate for children and adolescents with lupus was poor. However, advances in treatment and diagnosis have greatly improved the chances for a child with lupus.

Long Term Effects

Lupus is a multisystem disease and no two cases of Lupus in Children are the same. Pediatric lupus patients most commonly experience mucocutaneous (skin and mucous membranes), joint, muscle and kidney problems, but other systems may be involved. For many who develop lupus as children or adolescents, there is some form of long-term and permanent damage to organs from the disease or treatment.

  • At diagnosis, more than 60 percent of children and adolescents with lupus have inflammation of the joints. Nine out of ten children experience muscle or joint involvement at some point in the disease.
  • Approximately two-thirds of children with lupus develop kidney involvement at some point. In 9 out of 10 cases that do, the complication presents within the first year of diagnosis.
  • Approximately 50 percent of children and adolescents with lupus experience headaches from their lupus. Other less frequent neurologic complications include psychosis, movement problems, depression, and cognitive dysfunction
  • At diagnosis, half of the children and adolescents with lupus have blood involvement with anemia (low red blood cell count), a low white blood count and/or a low platelet count.

Complications of Treatment

Complications from the medications needed for treatment and management of lupus affect the child's developing body.

  • Lupus may be treated with medications that suppress the immune system. These make it difficult for the childÕs immune system to fight infection.
  • Some medications used to treat lupus (such as corticosteroids like prednisone), although necessary, may be detrimental to bone growth or bone blood flow. The pediatric lupus patient may go on to develop osteoporosis, osteonecrosis or have delayed growth.
  • Other common long-term complications from lupus and lupus treatments, particularly when corticosteroids (prednisone) are prescribed in moderate to high doses for disease management can include:
  • Serious infections
  • High blood pressure
  • Altered appearance
  • Delayed growth or short stature
  • Eye and vision problems
  • Chronic lung impairment
  • Fertility problems
  • Malignancy

Cause

The exact cause of Lupus in Children and Adolescents is not known but it is thought to be a combination of genetic factors and environmental triggers. Research in childhood lupus is crucial for preventing, treating and curing lupus. Much more research in this area needs to be done.


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