A clinical update on paediatric lupus

Abstract

Systemic lupus erythematosus in children is a life-threatening chronic disease that is being increasingly recognised. More black African children are being diagnosed and the proportion of males affected is much  higher than in adult-onset lupus. The presenting manifestations of childhood-onset lupus are variable and many systems are involved. Children with lupus often present late with severe disease, and in South African (SA) children severe lupus nephritis occurs commonly at presentation. The investigations for lupus should be  performed in a three-step process – initial essential investigations, antibody and serological tests, and  supplementary investigations. The most important factor in the management is to involve a multidisciplinary  team as soon as possible. All cases of lupus in SA should be discussed with a paediatric specialist so that a  tailored management plan can be made, depending on the presenting features and course of the disease.