Lupus in Children
May is National Lupus Awareness Month. Lupus is an inflammatory condition in the body that affects many organs.
I recently did an academic lecture on Multi Inflammatory Syndrome in Children, or MIS-C. It does share some overlap with other inflammatory disorders as well. This week, I’m going to answer some of your questions on lupus.
Q: What is lupus?
A: Systemic lupus erythematosus, also known as SLE, causes inflammation and even damage to organs in the body like most commonly, the kidneys and joints. Lupus affects each child and adult differently. The effects of the illness can range from mild to severe. Lupus affects more African-Americans and women. Lupus is an autoimmune disorder. In these disorders, the body's immune system attacks its own healthy cells and tissues.
Many factors are known to cause lupus. The factors are usually both genetic and environmental, and often affect one gender more than the other. The disease is known to have periods of flare-ups and remissions (partial or complete lack of symptoms).
Q: What signs should I look for in my child?
A: In children, Lupus is most frequent in those 15 or older. There are a number of very well known symptoms linked to lupus, and I’ll list the most common below:
- Serositis – Pleurisy, pericarditis
- Oral ulcers
- Blood disorders
- Renal involvement
- Antinuclear antibodies
- Immunologic phenomena
- Neurologic disorder
- Malar rash
- Discoid rash
Symptoms of lupus may resemble other medical conditions or problems. If you are concerned, consult with your child’s doctor. It is important to remember that having some of the above symptoms does not mean that your child has lupus. Always consult with a physician for a complete diagnosis and treatment plan.
Q: What are the potential complications of lupus?
A: Potential complications of lupus include:
- kidney disease (called nephritis),
- hematological (blood) problems frequently anemia.
- arthritis, or joint inflammation
In addition, all kids with lupus have a greater risk for developing infection. This is because their immune system is not working properly, but also because many lupus medications work by actually suppressing the immune system, further lowering the body’s defenses against invaders like bacteria and viruses.
Q: What is the treatment for lupus?
A: There is no cure for lupus, but many therapies can relieve some of the symptoms.
Treatment will be determined by your child’s doctor based on:
- Your child’s age, overall health and medical history
- Severity of the condition
- Your child’s tolerance for specific medications, procedures and therapies
- Specific organs that are affected
- Family’s opinion/preference.
Children with lupus require frequent monitoring by a rheumatologist to make sure the disease is under control and medications are not having side effects. Depending on what organ systems lupus is affecting, children may require care from specialists who take care of the kidneys (nephrologist), lungs (pulmonologist), skin (dermatologist), brain (neurologist) or heart (cardiologist).
So while there is no cure, in most cases, symptoms can be controlled through lifestyle changes and medications. Because having a chronic disease such as lupus is very stressful, children with lupus often benefit from seeing a mental health counselor such as a psychologist or licensed clinical social worker.
As we continue to learn more about MIS-C, we can take the knowledge we have of other inflammatory conditions and apply similar therapeutic strategies, as the UK and US have been thus far. While lupus is not an easy disease in any means. Once your child is diagnosed with lupus, there are many important ways you and your child can help in treating it. Stick to medications that your physician or rheumatologist recommends and alert your physician of new symptoms. Although we know lupus will never “go away” completely, these important steps can help to limit flares.