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Major Organ Involvement Common in Children With SLE

NEW YORK (Reuters Health) Apr 23 - Most children who have systemic lupus erythematosus (SLE) have a variety of serious clinical manifestations, Canadian researchers report in the April issue of the Journal of Pediatrics.

"In the largest single-center study of pediatric SLE, we found that the majority of patients with pediatric-onset SLE have a severe disease with evidence of major organ involvement," senior investigator Dr. Earl D. Silverman told Reuters Health.

Dr. Silverman and colleagues at the Hospital for Sick Children, Toronto, analyzed data from 256 patients who were diagnosed between 1982 and 2005. The mean age at diagnosis was 13.1 years and the most common symptoms at presentation were fatigue, fever and weight loss. Patients were followed for a mean of 3.5 years.

The most widespread clinical manifestations were arthritis (67%), malar rash (66%), nephritis (55%), and central nervous system (CNS) disease (27%). Children with both renal and CNS disease had the highest disease activity scores at diagnosis. However, by 1 year, these scores had normalized and were similar to those of the total group.

Patients who developed renal and CNS disease after 1 year also had higher SLE activity scores at diagnosis.

Overall, patients with these conditions had a greater frequency of damage than patients without major organ involvement.

Dr. Silverman pointed out that "with appropriate treatment most patients do well and only a minority have permanent damage."

In fact, he and his colleagues conclude that the outcome of pediatric SLE "has improved significantly since the initial reports."


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