SLE in children. Investigation and follow-up Please rate this page (bottom of page)

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Juvenil Systemic Lupus Erythematosus (SLE in Children)

Checklist for the investigation and follow-up of juvenil SLE

Diagnosis

  • EULAR / ACR and SLICC criteria can be used but not all points need to be present (non diagnostic classification criteria)
  • Antibodies as expected
    • ANA (close to 100%)
    • ENA (most)
    • Dna (54-93%)
    • Sm (17-52%)
    • RNP (22-50%)
    • SSA / Ro (33-54%)
    • SSB / La (14-32%)
  • Complement factors may be innate low (disposable for SLE) or in the course of the disease (C3, C4, CH50)
  • Heart and lungs are assessed by diagnosis
    • ECG
    • Rtg Thorax
    • Ultrasound of the heart (echocardiography)
    • If pulmonary symptoms, lung function tests, including gas diffusion (DLCO)
  • Inexplicably, high fever is investigated for Macrophage Activation Syndrome (MAS)
    • Clinical + cell count, coagulation factors, liver enzymes, ferritin, triglycerides). Evaluate bone marrow examination
    • Exclude sepsis
  • Consider signs of neuropsychiatric symptoms (CNS lupus)
    • If current cognitive dysfunction, epilepsy or psychosis is further investigated
      • MR, EEG, neuropsychiatric testing, ophthalmologist, spinal puncture

Follow-up / Monitoring

  • Clinical
    • Weight (and height of children)
    • Blood pressure
  • Urine stix (blood, proteins, sugar)
  • Blood tests (Blood lowering reaction / SR, cell deletions, liver enzymes, albumin, creatinine, estimated GFR, C3, C4, DNA)
  • Describe disease activity for example at (versions for children are also available):
    • SLEDAI
    • EXHIBIT
  • Eyelid Controls for Plaquenil Treatment (Hydroxyclorokine)
  • Repeat advice to
    • Remember to take the medications
    • Protection from direct sunlight
  • Cooperation with specialists is recommended

Literature

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