title: Management considerations for childhood-onset systemic lupus erythematosus patients and implications on therapy.
abstract: Childhood-onset systemic lupus erythematosus (cSLE) is a chronic inflammatory and autoimmune disease that may involve various organs and systems. This narrative review focuses on the recent evidence relating to cSLE management. The general management considerations of cSLE patients require the use of validated classification criteria, disease and health-related quality of life tools evaluation, as well as assessments of lupus nephritis biomarkers and cSLE quality indicators. The drug treatment for cSLE patients includes general supportive care and immunosuppressive therapy. Important implications on cSLE therapy are also updated such as infection, vaccination, infertility, pregnancy, contraception, dyslipidemia, physical activity, cancer, bone health, drug pharmacokinetics, adherence, academic outcomes, transition to adult care and cumulative organ damage.
authors.affiliation: a Pediatric Rheumatology Unit , Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil.|b Rheumatology Division , Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil.
authors.forename: Clovis Artur
authors.initials: CA
authors.lastname: Silva
authors.affiliation: a Pediatric Rheumatology Unit , Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil.|b Rheumatology Division , Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil.
authors.forename: Nadia Emi
authors.initials: NE
authors.lastname: Aikawa
authors.affiliation: b Rheumatology Division , Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil.
authors.forename: Rosa Maria Rodrigues
authors.initials: RM
authors.lastname: Pereira
authors.affiliation: a Pediatric Rheumatology Unit , Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil.
authors.forename: Lucia Maria Arruda
authors.initials: LM
authors.lastname: Campos
mesh_terms: D000328:Adult; D017668:Age of Onset; D000818:Animals; D002648:Child; D019468:Disease Management; D005260:Female; D006289:Health Planning Support; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000453:epidemiology*; D010349:Patient Compliance; D011247:Pregnancy
chemical_list: D007166:Immunosuppressive Agents
keywords: Childhood-onset systemic lupus erythematosus; cancer; dyslipidemia; exercise; fertility; immunosuppressive; infection; osteoporosis; vaccination; vitamin D