Childhood-onset systemic lupus erythematosus

Bundhun PK, et al. Differences in clinical features observed between childhood-onset versus adult-onset systemic lupus erythematosus: A systematic review and meta-analysis. Medicine (Baltimore). 2017 Sep;96(37):e8086.

Significant differences were observed between childhood-onset and adult-onset SLE. Childhood-onset SLE was associated with significantly higher adverse clinical features whereby neurological involvement, renal involvement, oral ulcers, malar rash, vasculitis, fever, ocular, and hematological manifestations were significantly higher, whereas pulmonary involvement, Raynaud phenomenon, and photosensitivity were significantly higher with adult-onset SLE. However, no significant difference was observed in gastrointestinal involvement, cardiovascular involvement, discoid rash, psychosis, alopecia, serositis, and arthritis.

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Couture J, Silverman ED. Update on the pathogenesis and treatment of childhood-onset systemic lupus erythematosus. Curr Opin Rheumatol. 2016 Sep;28(5):488-96.

This article will provide an update of studies published in the last year regarding epidemiology, pathogenesis, major disease manifestations and outcomes, and therapies in childhood-onset systemic lupus erythematosus (cSLE).

Recent studies on cSLE epidemiology supported previous findings that cSLE patients have more severe disease and tend to accumulate damage rapidly. Lupus nephritis remains frequent and is still a significant cause of morbidity and mortality. In the past year unfortunately there were no new reproducible, biomarker studies to help direct therapy of renal disease. However, some progress was made in neuropsychiatric disease assessment, with a new and promising automated test to screen for cognitive dysfunction reported. There were no prospective interventional treatment trials designed for patients with cSLE published in the last year, but some studies involving children are currently active and might improve the therapeutic options for patients with cSLE.

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Borgia RE, Silverman ED. Childhood-onset systemic lupus erythematosus: an update. Curr Opin Rheumatol. 2015 Sep;27(5):483-92.

Some progress in the pathophysiology of cSLE was made in the past year. Although biomarkers were studied in lupus nephritis and neuropsychiatric lupus, none of the proposed biomarkers was shown to be a significant improvement over current disease measures. More encouraging was the research into creating an easy, rapid screening tool for neurocognitive dysfunction in cSLE. Two studies in health-related quality of life (HRQL) recognized its importance in determining outcome and found that ethnicity and obesity might significantly alter HRQL in cSLE patients. There were no prospective clinical trials involving cSLE patients.

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More PubMed results on childhood-onset SLE.

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