Diagnosing Systemic Lupus in Children
“The criteria for diagnosing lupus in children are similar to those for a lupus diagnosis in adults. Since lupus is rare in children and can act like so many different diseases, there can be a delay in getting the right diagnosis,” notes Dr. MacDermott.
The American College of Rheumatology lists 11 criteria for diagnosing pediatric systemic lupus:
- Facial rash. The typical butterfly rash of lupus appears across the cheeks.
- Discoid rash. This is a raised, red, scaly rash that can cause scarring and temporary hair loss.
- Sensitivity to sunlight. Rashes and other lupus symptoms can be activated by ultraviolet light.
- Oral ulcers. People with lupus may have ulcers inside the nose or mouth similar to canker sores.
- Arthritis. Pain or swelling in two or more joints is common in pediatric lupus.
- Kidney involvement. Kidney involvement is common in pediatric lupus.
- Inflammation. The linings around the heart or the lungs can become inflamed.
- Nervous system involvement. Pediatric lupus patients may have seizures and exhibit psychiatric disturbances.
- Blood disorders. Lupus can cause a decrease in white or red blood cells.
- Immune system abnormalities. Just like adults, pediatric lupus patients produce antibodies against normal body cells that may be apparent on a blood test.
- Antinuclear antibody. This is the most common type of lupus antibody and is eventually found in almost everyone with lupus.
A diagnosis of systemic lupus can be made in children or teenagers who meet at least four of these criteria.