Systemic lupus erythematosus in childhood and adolescence

Systemic lupus erythematosus (SLE) is a heterogeneous multisystem autoimmune disease. Differential diagnoses to be considered include malignoma, infectious disease, and other rheumatic diseases. Rashes are a typical clinical feature at the time of diagnosis, followed by polyarthritis and renal pathology. Generalised lymphadenopathy and hepatosplenomegaly are common features, while neurological, pulmonary, and cardiac manifestations are infrequent. Renal involvement with SLE is more frequent in children than adults. Improved understanding of the immunopathogenesis of this disorder over the past two decades now affects therapeutic strategies, with treatment being directed at specific immunological targets. Treatment intensity needs to be balanced against its side effects.