title: Early onset systemic lupus erythematosus: differential diagnoses, clinical presentation, and treatment options.
abstract: Juvenile systemic lupus erythematosus is a rare multisystemic autoimmune disease with variable clinical manifestations, and disease onset before 16 years of age. Patients younger than 5 years are rarely affected and the age of onset may contribute to the course of disease in terms of clinical presentation, organ involvement, and serological findings. Here, we report two exemplary early-onset SLE patients, a 28-month-old patient with WHO class IIB kidney disease, arthritis, and a typical antibody constellation and an 11-month-old infant that presented with microcytic anemia, leukocytosis, arthritis, fasciitis, fatty liver disease, protein losing enteropathy, edema, and minimal change glomerulonephritis. Epidemiologic and clinical features of early-onset SLE compared to other forms of SLE are given and differential diagnoses and treatment options are discussed.
authors.affiliation: Pediatric Rheumatology and Immunology Section, University Children's Hospital Dresden, University Medical Center Garl Gustav Carus, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany. christian.hedrich@uniklinikum-dresden.de
authors.forename: Christian Michael
authors.initials: CM
authors.lastname: Hedrich
authors.forename: Hildegard
authors.initials: H
authors.lastname: Zappel
authors.forename: Simon
authors.initials: S
authors.lastname: Straub
authors.forename: Martin W
authors.initials: MW
authors.lastname: Laass
authors.forename: Kathrin
authors.initials: K
authors.lastname: Wieczorek
authors.forename: Gabriele
authors.initials: G
authors.lastname: Hahn
authors.forename: Georg
authors.initials: G
authors.lastname: Heubner
authors.forename: Manfred
authors.initials: M
authors.lastname: Gahr
mesh_terms: D017668:Age of Onset; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology; D008727:Methotrexate / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D011241:Prednisone; D008727:Methotrexate