INTRODUCTION

Systemic lupus erythematosus (SLE) in children is fundamentally the same disease as in adults with similar etiology, pathogenesis, clinical manifestations, and laboratory findings. However, the care of children and adolescents with SLE is very different from that of adults because of the impact of the disease and its therapy on physical and psychological growth and development. (See "Overview of the clinical manifestations of systemic lupus erythematosus in adults".)

Failure of therapy of childhood SLE frequently results from efforts to care for a child or adolescent with a complex and chronic disease without considering the special needs of the growing individual and his or her family. As a result, clinicians who are unprepared to deal with these needs should refer these patients to a pediatric rheumatology center.

EPIDEMIOLOGY

The current best estimate is that SLE affects between 5000 and 10,000 children in the United States [1]. Childhood SLE affects girls more often than boys (8:1), even in the prepubescent age group (4:1). Although it can occur at any age, SLE becomes more frequent after five years of age and is increasingly prevalent after the first decade of life [2]. (See "Epidemiology and pathogenesis of systemic lupus erythematosus", section on 'Epidemiology'.)

Because the incidence and severity of childhood SLE vary by race, a comparison of data from institutions serving racially diverse populations is generally unrevealing [2]. Patients of Asian, African, or Latino ethnicity are all more frequently affected than Caucasians. Estimates of disease incidence between the ages of 10 and 18 in the United States among females of different ethnic groups are:

• 31 cases per 100,000 female Asians
• 20 cases per 100,000 blacks
• 13 cases per 100,000 Hispanics
• 4 cases per 100,000 whites