P e d i a t r i c L u p u s — A re T h e re D i ff e ren c e s i n P re s e n t a t i o n , Genetics, Response t o T h e r a p y, a n d Damage Accrual C o m p a re d w i t h Adult Lupus?
Rina Mina,
MD,

Hermine I. Brunner,

MD*

KEYWORDS  Pediatric SLE  Children  Lupus  Adults  Lupus nephritis  Complement

An estimated 10% to 20% of patients experience the onset of systemic lupus erythematosus (SLE) before adulthood. More precise estimates are difficult due to a lack of a clear age limit for the diagnosis of pediatric SLE. The maximum age at diagnosis most commonly used to define pediatric SLE is 16 years but ages range from 14 to 20 years in various studies.1–8 This review article explores the differences and similarities …ver más…

Specific details are presented in Tables 2 and 3.2,4,5,17,24 The variability in the estimates between studies may be a reflection of sample sizes or recruitment criteria but true divergence of SLE features due to race, ethnicity, and specific environmental or health milieus is likely also important. This review excludes some earlier studies that compared pediatric SLE to historic aSLE cohorts or research not designed to allow for the delineation of statistically significant differences between the groups.7,25
MUCOCUTANEOUS AND MUSCULOSKELETAL MANIFESTATIONS

When directly comparing pediatric SLE to aSLE, inflammatory rashes, including the typical malar erythema, are significantly more frequent in children than adults.2,5,24 Exceptions are photosensitivity and discoid skin lesions that are more prominently found with aSLE. Isolated discoid lupus erythematosus (DLE) is uncommon in childhood, with fewer than 5% of all DLE cases reported in patients under the age 15.2,26 Lesions of DLE in children are indistinguishable from those in adults but children with DLE suffer less often from photosensitivity, and there is a less pronounced female predominance. Conversely, children with DLE more often have a positive