SYSTEMIC LUPUS ERYTHEMATOSUS IN CHILDHOOD

Abstract

Data on 42 children with systemic lupus erythematosus have been analyzed and compared with data from 200 adults with the disease. Among the children, the age of onset ranged from 3 to 15 years of age, with a peak for girls during adolescence. The age of onset among male patients, both adult and children, was constant for all decades and there was no cluster at any particular age. The disease in children was similar to that in adults except for a higher incidence of hepatosplenomegaly and lymphadenopathy among the children. Renal disease occurred with similar frequency in the two groups. It was generally unusual for additional system involvement to occur following diagnosis, although some patients who had no renal disease at the time of diagnosis did develop renal disease subsequently. Combined antimalarial and moderately high dose steroid therapy was employed. Renal involvement at the time of diagnosis reduced survival among both the adults and the children. The prognosis in childhood was decidedly worse than in adults. Models of survival were developed based upon crude mortality rates. Similar survival models may serve to study prognosis of other diseases and other management of lupus.