Clinical features of systemic lupus erythematosus (SLE) in children and adolescents

Massias, 2020

Note: Systemic lupus erythematosus with multisystem involvement is more common in children and adolescents than in adults.

The clinical features of systemic lupus erythematosus (SLE) in children and adolescents are very similar to those in adults; however, multisystem involvement is more common. See Clinical features of SLE and System-related features of SLE for more details of the condition in adults. Organ- or life-threatening features in children and adolescents with SLE often involve:

  • kidneys—in 20 to 40% of first presentations and in up to 70% of patients over time
  • the central nervous system (CNS)—neuropsychiatric features can occur in 10 to 40% of first presentations and in up to 30% of patients over time
  • haematological abnormalities (eg cytopenias, macrophage activation syndrome1)
  • vasculitisHuang, 2022.

Mortality associated with SLE in children and adolescents is similar to that in adultsHuang, 2022.

1 Macrophage activation syndrome (MAS) is characterised by fever, hepatosplenomegaly, abnormal clotting profile (mimicking disseminated intravascular coagulation), abnormal liver function, cytopenias and extreme hyperferritinaemia. Urgently refer children or adolescents with suspected MAS to a centre of expertise.Return