title: Childhood-onset Systemic Lupus Erythematosus: clinical presentation and prognosis in 31 patients.
abstract: OBJECTIVE
  To determine the clinical features at onset, the disease course, and prognostic factors in children with SLE.
  
  
  METHODS
  The medical records of 31 patients with childhood-onset SLE were reviewed. Signs and symptoms at onset and during the course of the disease were documented as well as survival and SLICC/ACR damage index. The disease course was compared to 135 consecutive adult-onset SLE patients.
  
  
  RESULTS
  Childhood-onset SLE most frequently presented with fatigue, arthritis, fever, weight loss, and malar rash. During follow-up, the frequency of the presence of malar rash, anemia, leukocytopenia, and anti-dsDNA antibodies was significantly higher in childhood-onset than in adult-onset patients. Mean SLICC/ACR damage index was 2.6 after 4.7 years of follow-up. The presence of arthritis, anemia, and seizures at the onset of disease resulted in a 2.6 to 3.9 times higher chance of a severe disease course.
  
  
  CONCLUSIONS
  Patients with childhood-onset SLE suffer from substantial morbidity. Arthritis, anemia, and seizures at onset may be indicators of poor prognosis.
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Rood
authors.forename: R
authors.initials: R
authors.lastname: ten Cate
authors.forename: L W
authors.initials: LW
authors.lastname: van Suijlekom-Smit
authors.forename: E J
authors.initials: EJ
authors.lastname: den Ouden
authors.forename: F E
authors.initials: FE
authors.lastname: Ouwerkerk
authors.forename: F C
authors.initials: FC
authors.lastname: Breedveld
authors.forename: T W
authors.initials: TW
authors.lastname: Huizinga
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001168:Arthritis; D001323:Autoantibodies / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005076:Exanthema; D005221:Fatigue; D005334:Fever; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D015431:Weight Loss
chemical_list: D001323:Autoantibodies