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Systemic lupus erythematosus (SLE) in children: Clinical manifestations and diagnosis

INTRODUCTION

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause that can affect the skin, joints, kidneys, lungs, nervous system, serous membranes, and/or other organs of the body. 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 different from that of adults because of the impact of the disease and its therapy on physical and psychologic growth and development. (See "Overview of the clinical manifestations of systemic lupus erythematosus in adults".)

The epidemiology, clinical features, diagnosis, and classification of SLE in children are reviewed here. The treatment, complications, and prognosis of SLE in children are discussed separately. (See "Systemic lupus erythematosus (SLE) in children: Treatment, complications, and prognosis".)

EPIDEMIOLOGY

The 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). SLE can occur at any age, although it becomes more frequent after five years of age and is increasingly prevalent after the first decade of life [2]. In retrospective reviews from France, Canada, and the United Kingdom, the median age of onset of juvenile SLE was 12 to 13 years, with the disease developing in the majority of patients after eight years of age [3-5]. (See "Epidemiology and pathogenesis of systemic lupus erythematosus", section on 'Epidemiology'.)

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

31 cases per 100,000 for Asians

                               

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Literature review current through: Nov 2014. | This topic last updated: Nov 14, 2014.
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