Systemic%20lupus%20erythematosus%20(pediatric) Signs and Symptoms

Signs and Symptoms

Definition

Systemic lupus erythematosus (SLE) is a chronic, multisystem, inflammatory, autoimmune disorder characterized by formation of autoantibodies directed against self-antigens and immune-complex formation
- SLE can be diagnosed with a single organ involvement such as lupus nephritis
Childhood-onset SLE (cSLE) has an estimated worldwide incidence of 0.3-2.2 per 100,000 children-years with prevalence ranging from 3.3-9.7 per 100,000 children and adolescents
- Occurrence is rare before 5 years of age
Females are more often affected than males
Clinical presentation varies in different patients and the disease activity varies over time in a single patient
- Most frequent manifestations in children include fever, rash, weight loss, arthritis and renal involvement
- Compared with adults, cSLE has a higher incidence of fever, lymphadenopathy, ocular symptoms, hematologic abnormalities (eg anemia, leukopenia), neurologic (seizures) and renal involvement (lupus nephritis)
  - cSLE has a greater disease severity and earlier disease damage than in adults with SLE

Signs and Symptoms

Clinical Features of SLE

Cardiac
- Endocarditis
- Myocarditis
- Pericarditis

Constitutional
- Fatigue
- Fever
- Weight loss

Dermatological
- Alopecia
- Malar and/or discoid rash
- Mucous membrane lesion
- Photosensitivity
- Purpura
- Raynaud’s phenomenon
- Urticaria
- Vasculitis

Gastrointestinal
- Abdominal pain
- Nausea, vomiting (N/V)

Hematologic
- Anemia
- Leukopenia
- Lymphopenia
- Thrombocytopenia

Thromboembolic
- Deep vein thrombosis
- Cerebral sinus venous thrombosis
- Pulmonary embolus
- Arterial stroke

Musculoskeletal
- Arthralgia
- Arthritis
- Myositis

Neuropsychiatric
- Headache
- Cognitive impairment
- Mood or anxiety disorders
- Psychosis
- Seizures
- Cerebrovascular disease

Pulmonary
- Pleurisy
- Pulmonary hypertension
- Pneumonitis

Renal
- Casts
- Hematuria
- Nephrotic syndrome
- Proteinuria

Reticuloendothelial
- Hepatomegaly
- Lymphadenopathy
- Splenomegaly

Impact Dermatology Masterclass 2019

30 Oct 2019

In a sponsored IMPACT Dermatology Masterclass 2019 by DCH Auriga, the latest dermatological insights were shared by Professor Dr Helmut Schöfer on sertaconazole for fungal infections, and Dr Cheong Wai Kwong on innovations in atopic dermatitis management.

Navigating the CPP patient journey – case-based discussion for nurses

06 May 2021

In a webinar held on 27 March 2021, paediatric endocrinology nurses Karen Blair, Kate Davies, and Siti Zarina Yaakop shared insights and clinical experience based on their frontline roles in caring for patients with central precocious puberty (CPP) and supporting their family members.

Advancing into the era of CAR T-cell therapies: Tisagenlecleucel in the treatment of B-cell acute lymphoblastic leukaemia and diffuse large B-cell lymphoma

Prof. Franco Locatelli, Dr. Udo Holtick, Dr. Francesca Lim, 21 May 2021

Tisagenlecleucel is the first therapy to be approved by the Singapore Health Sciences Authority under the Cell Tissue and Gene Therapy Product Regulations enacted on 1 March 2021. On 4 March 2021, Novartis organized a launch symposium for tisagenlecleucel, a CD19 chimeric antigen receptor (CAR) T-cell therapy approved for the treatment of paediatric and young adult patients with relapsed/refractory (r/r) acute lymphoblastic leukaemia (ALL) and adults with r/r diffuse large B-cell lymphoma (DLBCL) after two or more lines of systemic therapy. The invited speakers were Prof Franco Locatelli from the Sapienza University of Rome, Italy, Dr Udo Holtick from the University Hospital of Cologne, Germany, and Dr Francesca Lim from Singapore General Hospital, Singapore. Prof William Hwang from National Cancer Centre, Singapore, chaired the symposium.