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 lupus children. 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 lupus children 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 children is difficult to diagnose due to the
vague symptoms in the beginning. The
lupus
diagnosis includes 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
lupus blood test and a urine test will show if there is kidney
involvement.
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 in lupus children 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.
Pediatric lupus
patients almost always experience kidney problems,
spleen enlargement and anemia. Another complication of
lupus in children 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.
Lupus in children 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, lupus children 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 lupus in children 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.
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
for lupus can also help.
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Lupus in
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