Systemic Lupus Erythematosus

How Lupus Affects the Body

Lupus is unpredictable in which body parts are affected and to what extent. It can attack the joints, skin, blood vessels and even organs such as the kidneys, lungs and heart, and can cause pain, fatigue and other symptoms. People with lupus often experience periods of flare-ups in which symptoms worsen, and periods in which symptoms ease and the disease goes into remission. Though there is no known cure, patients with lupus can manage their symptoms with medications and other therapies, as well as lifestyle adjustments.

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Who Is at Risk for Lupus?

Lupus occurs most often in young women in their late teens and adult women younger than age 45. The female hormone estrogen is linked with lupus. Lupus also affects more African Americans, Asian Americans, Hispanics and American Indians than whites. Lupus in children occurs most often in those age 15 and older. But it can happen in children or adults of any age.

About 15 percent of lupus cases occur in patients under age 18. Lupus tends to develop more quickly in children, who are more likely to sustain longer-term organ damage in vital organs such as the kidneys and nervous system. However, just like with adults, lupus can range from mild to severe in children.

The exact cause of lupus is unknown, but experts believe genetics, hormones and environment can all play a factor.

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Lupus Symptoms and Signs

Symptoms of lupus vary greatly from person to person. Some of its earliest symptoms – such as fever or fatigue – can be mistaken for other common illnesses. Common signs of lupus include:

• Fatigue
• Joint and muscle pain
• Loss of appetite
• Weight loss
• Fever
• Skin rashes
• Weak or brittle hair/hair loss
• Ulcers in the mouth or nose
• Dark urine
• Swelling of the feet, legs or eyelids
• Shortness of breath
• Headaches
• Seizures

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Diagnosing Lupus

To diagnose pediatric lupus, your child’s doctor will perform a physical exam, review symptoms and medical history, and order a series of tests. There is no one test that can diagnose lupus, so your child may need to undergo:

• Blood tests to check for blood counts, anemia and other abnormalities
• Urine tests to check for protein in the urine
• Antinuclear antibody (ANA) screening to test for antibodies present in people with lupus
• Biopsies of the skin or kidneys
• X-rays

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Lupus Treatments and Therapies

Your child’s pediatric rheumatologist will work with other UH Rainbow pediatric specialists as needed to develop an individualized treatment plan. The goal is to help manage symptoms, minimize flare-ups and prevent organ damage. Medications that can be used to treat lupus in children include:

 

• Anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs (NSAIDS) and corticosteroids.
• Anti-malarial medication, such as hydrochloroquine, which can be used to ease symptoms such as fatigue, rashes and joint pain
• Immune system-suppressing medications
• Biologic agents to help prevent the immune system from attacking the body
• Disease-modifying anti-rheumatic drugs (DMARDs)
• Anticoagulants to help prevent blood clots

Additional ways to help manage your child’s lupus symptoms include getting plenty of rest, eating a healthy diet, getting moderate exercise, and limiting sunlight exposure and using sun protection.

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Continuing Care for Managing Symptoms

It is important for your child to have regular follow-up appointments with their pediatric rheumatology to discuss any new or worsening symptoms, assess current treatment plan, and prescribe new medications and therapies as needed. As your child gets older, the pediatric rheumatology team will work with them to facilitate a smooth transition to adult rheumatology care.