Pediatric Systemic Lupus Erythematosus: More Than a Positive Antinuclear Antibody

Pediatric systemic lupus erythematosus (pSLE) was described as a severe autoimmune disease that presents more aggressively in children than adults, affecting various organ systems and leading to significant morbidity. Ethnicity influenced incidence rates, with higher rates in certain populations. Treatment advancements included the FDA approval of belimumab and the continued use of hydroxychloroquine. Renal disease affected up to 65% of pSLE patients, requiring aggressive treatment. Genetic, environmental, and hormonal factors contributed to the disease's pathogenesis. Early diagnosis and comprehensive management were crucial for improving outcomes. Complications like neuropsychiatric involvement, cytopenias, and antiphospholipid antibody syndrome required tailored treatments. Pulmonary and cardiac issues, including pericarditis and premature atherosclerosis, were also noted. Monitoring disease activity and managing complications like hypertension and infections were emphasized. Neonatal lupus erythematosus (NLE) and drug-induced lupus (DIL) were discussed, with specific treatment approaches. Corticosteroids were a mainstay but had significant side effects. A multidisciplinary team approach was essential for optimal care.