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
- If current cognitive dysfunction, epilepsy or psychosis is further investigated
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
- Reference Great N, 2017
- Generally about investigation and journal writing at SLE, please read here (in Danish)
- About SLE among adults, please read here (in Danish)
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