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Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
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Lupus Nephritis.
Scott E Wenderfer1, Karen W Eldin2
1Pediatric Nephrology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 1102 Bates Avenue, Suite 245, Houston, TX 77030, USA.
Pediatric Clinics of North America
|November 21, 2018
Summary
Childhood-onset systemic lupus erythematosus (SLE) presents unique challenges, often involving more severe disease and kidney complications. While mortality is lower than in adults, long-term damage and relapses remain significant concerns for pediatric patients.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Nephrology
Background:
- Childhood-onset systemic lupus erythematosus (SLE) is defined as SLE with onset before 18 years of age.
- This subset often exhibits a stronger genetic predisposition, extensive multisystemic involvement, and a more aggressive disease trajectory compared to adult-onset SLE.
- Key concerns include a higher risk of nephritis and end-stage kidney disease.
Purpose of the Study:
- To summarize the distinct characteristics and clinical course of childhood-onset SLE.
- To highlight the challenges in managing long-term outcomes, including organ damage and complications.
- To underscore the importance of effective immunosuppressive strategies in pediatric lupus patients.
Main Methods:
- Review of existing literature on childhood-onset SLE.
- Analysis of clinical data pertaining to disease severity, organ involvement, and treatment outcomes.
- Comparative assessment of pediatric versus adult-onset SLE patient populations.
Main Results:
- Childhood-onset SLE is associated with greater genetic influence and more widespread organ system engagement.
- Despite lower short-term mortality rates compared to adult SLE, patients face significant risks of nephritis and irreversible organ damage.
- Cardiovascular issues, infections, and disease relapses, particularly during adolescence and young adulthood, are common.
Conclusions:
- Advances in immunosuppression have improved survival but have not eliminated the risk of cumulative damage in childhood-onset SLE.
- Long-term management requires vigilant monitoring for cardiovascular complications, infections, and disease flares.
- Addressing the unique trajectory of pediatric lupus is crucial for optimizing patient outcomes and quality of life.
