The type of lupus that affects the child is referred to as childhood lupus or pediatric lupus. The symptoms mimic that of the adult form of systemic lupus erythematosus but have different consequences and frequencies in the child. Pediatric lupus is more complicated than the adult form of lupus due to the fact that it affects a child's physical and emotional growth.

As recently as twenty years ago, the prognosis and survival rate for childhood lupus patients was poor. Major advances in treatment and diagnosis, however, have improved the chances of a child with pediatric lupus greatly. A long-term treatment plan is necessary in order to take into consideration the development of the child into an adult.

Lupus in a child is difficult to diagnose due to the vague symptoms in the beginning. Childhood lupus can be diagnosed with a complete medical history review, a physical examination and blood and urine tests. The doctor will go over the medical history of the child to determine how many lupus symptoms are present, how long they have been going on and the severity of symptoms. A blood test is used to determine is there are any antibodies present in the blood that are consistent with the antibodies of childhood lupus patients. Another blood test and a urine test will show if there is kidney involvement.

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Another test for childhood lupus is the complement test. If the child has low levels of complement (proteins that help kill foreign substances in the blood) the child may have lupus. X-rays are also used to study the internal organs for inflammation.

In addition, the child must have at least four of the following symptoms of childhood lupus to be diagnosed with the disease: Positive blood tests, discoid rash (a raised, red, scaly rash that is coin shaped, usually on the head, chest, arms or back), photosensitivity, heart or lung involvement, joint inflammation and pain, kidney problems, changes in normal blood values, malar rash (a butterfly shaped rash extending across the bridge of the nose and cheeks), mouth or nose ulcers, seizures or other neurological problems.

The symptoms of lupus in the child may be vague, consisting of tiredness, weakness, weight loss, rashes, fever and pain in the joints. These symptoms may go on for several months before the more serious symptoms manifest themselves. Unfortunately, childhood lupus patients do not have much of a chance of the disease stopping with the mild symptoms as it often does in adult lupus.

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Pediatric lupus patients almost always experience kidney problems, spleen enlargement and anemia. Another complication of lupus in child is the affect of corticosteroids on the child's developing body. These drugs, necessary to treat childhood lupus, are detrimental to bone growth, bone blood flow and infection resistance. The pediatric lupus patient may go on to develop osteoporosis and osteoncrosis as a result. In addition, drugs used to suppress the immune system and non steroid drugs make it difficult for the child�s immune system to fight infection. Another complication of lupus in child is that they are more likely to develop arthrosclerosis early.

To prevent pediatric lupus patients from experiencing these complications, it is important that the child eats a healthy diet, watching cholesterol and taking dietary supplements, especially calcium, as well as timing immunizations and not taking any immunizations that have live bacteria or viruses in them (such as chicken pox an MMR). The childhood lupus patient must be checked for high blood pressure and cholesterol. Medication to lower these may be prescribed.

Pediatric lupus accounts for 20% of lupus patients. Females are more likely to get pediatric lupus than males. Childhood lupus starts most frequently in late childhood or early adolescence, but may start at any time in childhood. Predisposition to lupus in child is hereditary based on the evidence that the vast majority of pediatric lupus patients have a family member with SLE or a similar disease. Boys who have Klinefelter's syndrome (a male child is born with an extra X chromosome) develop pediatric lupus at a very high rate. In addition, childhood lupus patients frequently had parents of siblings that had been tested to find anti-nuclear antibodies even though these parents and siblings exhibited no symptoms.

Treatment for childhood lupus is individual, depending on the child's health and medical history and severity of symptoms, medication tolerance, therapy tolerance, prognosis, organ involvement and treatment preferences. When symptoms are mild, only nonsteroidal anti-inflammatory drugs (NSAIDs) may be necessary.

When symptoms are more severe, which is often the case in childhood lupus, treatment with the medications chloroquine, quinacrine, hydroxychloroquine, corticosteroids, and immunosuppressive medications may be used alone or in combination. When organs are involved, the drug prednisone may be used. Unfortunately, prednisone has the detrimental side effects of causing cushinggoid, acne and lots of facial and body hair. Skin rashes can be prevented or decreased with avoiding too much sun, using sunscreen and protective clothing when out of doors. Enough rest can help combat fatigue. Stress reducing techniques, treating infections promptly and eating a proper diet can also help.
 

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