Childhood systemic lupus erythematosus (SLE) is a severe autoimmune disease that occurs when the immune system is overactive and mistakenly attacks the body, causing inflammation in many organs, including skin rash, joint swelling with pain, kidney problems, lung inflammation and disorders of the nervous system. This causes severe multisystem disease that can lead to organ damage.
Other symptoms of childhood systemic lupus erythematosus include:
- Fatigue
- Anemia
- Rashes due to sun exposure that last a week or more
- Bleeding problems
- High blood pressure
- Proteinuria (protein in the urine)
- Hematuria (blood in the urine)
- Fever without infection
- Weight loss
- Hair loss, often leaving bald spots
- Stomach pain
- Headaches
- Bruising easily
- Seizures or psychosis
- Decline in performance at school
- Symptoms of anxiety or depression
The exact causes of SLE are unknown, but some patients are born with genetic factors that make them more prone to developing it. Some environmental conditions can trigger the immune response that causes lupus. These possible triggers are:
- Epstein-Barr virus (a common virus that causes mononucleosis, or mono)
- Sun exposure
- Drug reaction
- Puberty hormones
Diagnosis of Childhood Systemic Lupus Erythematosus
Your child’s doctor will use results from one or more of the following blood tests—in combination with the presence of the above symptoms—to diagnose childhood systemic lupus erythematosus:
- Complete blood count (CBC). Low counts of red blood cells, white blood cells or platelets may indicate SLE.
- Antinuclear antibodies test. High levels of antinuclear antibodies (ANA)—an immune system protein that attacks the nuclei of cells—may point to SLE but low to moderate amounts of ANA is common in childhood.
- Complement test. The complement system is made up of proteins that help the immune system function. Low levels of C3 and C4 complement system proteins suggest SLE.
- Other blood autoantibody tests. Abnormal results for other immune system antibodies can help diagnose childhood systemic lupus erythematosus.
If your child has blood or protein in his or her urine, the rheumatologist will likely need to order a kidney biopsy to determine what kind of kidney inflammation is occurring and how to treat that inflammation.
If your child’s rheumatologist confirms a diagnosis of childhood systemic lupus erythematosus, it is important that you follow the recommended treatment plan in order to decrease the chance of serious complications and effects. Note that the course of the disease is usually worse in the first two to three years after diagnosis. Symptoms typically diminish somewhat after that.
Treatments
Treatments
Lupus has no cure, but proper treatment can help ease the symptoms, slow its progression and prevent damage. The pediatric rheumatologist will determine appropriate treatment for SLE based on how severe the symptoms of the condition are for your child. The purpose of treatment is to suppress the autoimmune process, prevent damage to the affected organs and restore health. Your child may be prescribed one or more of the following medicines in specific combinations:
- Corticosteroids. Corticosteroids like prednisone are used to control inflammation.
- Hydroxychloroquine. Hydroxychloroquine (Plaquenil), an anti-malaria medicine, is usually used to control lupus.
- Immunosuppressants. These types of medicines are used to reduce the over-activity of the immune system that causes the symptoms of SLE.
- Pain relievers. Medicines like ibuprofen or naproxen may be used to reduce pain caused by swelling in the joints. Do not use them without checking with your child's rheumatologist first, though, as they can cause trouble if the lupus has attacked the kidneys.
- Calcium and Vitamin D supplements. Your child’s doctor may prescribe these supplements to help prevent osteoporosis, which is a possible side effect of long-term use of corticosteroids.
All children with lupus are advised to avoid direct sun exposure, as sunlight can act as a stimulant to the autoimmune response. Patients with lupus should follow a low-fat, heart-healthy diet as well as get regular exercise and adequate sleep; they often need more sleep than their friends.
Key Points to Remember
Key Points to Remember
- Childhood systemic lupus erythematosus (SLE) occurs when an overactive immune system causes severe multisystem disease that can lead to organ damage.
- Lupus can affect nearly every organ system in the body, so it is important to seek and follow the treatment of a pediatric rheumatologist.
- There is no cure for SLE, but the symptoms can be controlled with a combination of medicines.
- Children with systemic lupus erythematosus should avoid exposure to direct sunlight, as it can trigger flare-ups of the condition.
Support Services & Resources
Support Services & Resources
Visit the trusted websites below to learn more about childhood systemic lupus erythematosus.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
The American College of Rheumatology provides detailed information about systemic lupus erythematosus in children and teens.
The American College of Rheumatology supports The Lupus Initiative, which provides resources and support for lupus patients and their families.
The Arthritis Foundation provides information on childhood systemic lupus erythematosus, including details on its causes, symptoms and self-care.
The Lupus Foundation has valuable educational information about lupus and supports research on lupus.
Childhood Systemic Lupus Erythematosus Research
Childhood Systemic Lupus Erythematosus Research
The pediatric rheumatologists at Riley at IU Health are currently involved in several research studies for childhood systemic erythematosus. One study seeks to understand how the hormones produced during puberty affect systemic lupus erythematosus and how hormones influence the function of the immune system. Another study is looking to see how HER2 (a small regulator of gene expression) predicts lupus nephritis—this study is being conducted in collaboration with the Children's Hospital of Philadelphia. We also participate in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. Your child's doctor can provide more information about participation in these research studies and clinical trials.
Locations
Locations
Locations
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.
Riley Pediatric Rheumatology
11725 N. Illinois St.
Carmel, IN 46032
Riley Pediatric Rheumatology
575 Riley Hospital Dr
Indianapolis, IN 46202