Studies on juvenile systemic lupus erythematosus (SLE) have intensified in recent times. Moreover, new discoveries have surfaced on the disease.
Studies have also shown that SLE is more aggressive in children than in adults. It is important to note that few studies have been done on the utility of biologics. In addition, studies on depletion therapy in juvenile SLE have been scarce. This paper will explore juvenile SLE. It will also explore its signs, symptoms, diagnosis, prognosis, statistics, treatment, complications, risk factors, and diet (Habibi & Ramanan, 2012, p. 81-93).
Systemic Lupus Erythematosus Juvenile
Juvenile SLE, which is sometimes called Lupus, refers to an autoimmune disorder. It usually affects young people as well as children. The age of the former at risk of infection is usually under 18 years. This disease has the capability of affecting any part of the body. However, it is quite common in joints. Usually, it is referred to as autoimmune arthritis.
The disease is usually characterized by early signs, which can be likened to those that show in other diseases. Usually, this can lead to misleading treatment without knowing that Lupus is an infectious disease. In this regard, many people have found themselves treating different diseases when Lupus is at its early stages in the patient.
Moreover, the symptoms usually come and go even after diagnosis. This makes it difficult to track its movements in the body. Moreover, in such cases, it is quite common to see new symptoms. In this case, other symptoms may be resolved. To crown it all, these symptoms may vary from one patient to another.
In essence, the diagnosis of juvenile SLE is very difficult as it comes with several complications that vary from one individual to another. Symptoms such as fatigue and muscle aches are quite common in patients with juvenile SLE. Studies have it that children with juvenile SLE have a high risk of complications with their organs as compared to their adult counterparts.
These may include problems in organs such as the brain and kidneys, among others. However, it is important to note that the disease is not contagious. Furthermore, studies have shown little progress in determining the causes of SLE. This is quite similar to other autoimmune disorders. It has also been discovered that a parent with Lupus has a minimal chance of 5% to pass SLE to his/her children.
Moreover, in the case where it is passed to twins, then only one of the twins can have the disease. In this regard, it is commonly agreed that SLE is caused by other external causes other than genetics. Moreover, due to its commonality in females, it has also been suggested that hormones play significant roles in its acquisition (El-Ghoneimy, Awad & Mostafa, 2012, p. 115).
Before a diagnosis is made, there is usually a list of symptoms observed. In most cases, four or more symptoms are required to allow for diagnosis. These include Malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, cardiopulmonary problems, neurological problems, kidney problems, hematologic problems, positive ANA blood test, and other positive blood tests.
These are usually referred to as the eleven criteria for Lupus. In essence, four of the eleven criteria listed above must be fulfilled for diagnosis to be performed on patients. Usually, the process is quite complicated. In this regard, a number of factors are usually taken into account during diagnosis. For instance, the number of blood tests is sometimes utilized.
In this regard, a complete blood count is usually done (CBC). This also involves looking at Antibody (ANA). Others include Anti-DNA, Complement (C3 andC4), C – reactive protein (CRP), and Erythrocyte sedimentation rate (ESR or sed. rate).
In most cases, these tests are also used late to help in monitoring the progression of SLE. It is also necessary to note the other tests that are usually conducted include X-rays, for testing inflammations that may occur near important organs, among others.
In addition, biopsies can also be utilized in place of X-rays. In essence, the whole process of diagnosis is usually complicated as it depends on the symptoms and the individual being tested (International Autoimmune Arthritis Movement 2013, p. 1-3).
Signs and Symptoms
Early signs of Juvenile SLE are usually similar to those observed in patients with other diseases. This commonly brings about confusion as to which disease is predominant. However, the common symptoms characterized by SLE patients include fatigue and loss of weight/appetite, among others. Other symptoms include swollen joints, which are usually aching, muscle aches, and fevers.
Still, others include skin rashes and hair loss as well as ulcers in the mouth or nose. Some patients also have color changes. Moreover, in situations where children are affected, their risk of issues with organs is high, and this is usually characterized by dark urine, swelling legs, feet, and eyelids.
Other symptoms of infected organs include shortness of breath as well as chest pains. In addition, other signs may include seizures, memory problems, and headaches. It is also quite necessary to note that children with SLE disease are at higher risk of organ infections as compared to their adult counterparts (El-Ghoneimy, Awad & Mostafa, 2012, p. 115).
Future research on juvenile SLE will focus on understanding the pathogenesis of the rheumatic disease. It will also focus on cytokines as well as other small molecules involved. It is also expected that further research will be conducted in providing efficacy for small molecule inhibitors, which can be administered orally.
Moreover, more research is being conducted on understanding the unknown side effects of SLE. In addition, studies will also be conducted on the withdrawal of biologics as well as on the rate of sustained reduction of drugs. Moreover, it is expected that pharmacogenomics will help in predicting children responding to specific biologic or developing side effects, among others (WebMD, LLC., 2013, p. 1).
Lupus foundation has shown that nearly one and a half million people have Lupus in the U.S. alone. Moreover, the study shows that Asians, Africans, and Native Americans are highly likely to have SLE as opposed to their Caucasian counterparts. Studies also show that the most common age for the onset of SLE in young people is between 15 and 18 years.
At this age, SLE usually acts as it is at the onset of adult SLE. Statistics also show that it rarely starts below the age of 15 years. Furthermore, statistics show that on rare occasions do children under the age of 5 develop Juvenile SLE. Again, it shows that more than 90% of females make up all cases of SLE.
Medications utilized for SLE patients can be put into two main groups, namely immunosuppressant or non-immunosuppressant. The former medications are milder medicines utilized to fight swellings. They are usually utilized to ease discomfort in patients with Juvenile SLE. On the other hand, the latter medications are powerful.
They are usually used to control the malfunctioning immune system. In some cases, this brings about the suppression of the immune system, which may lead to the risk of infections. Usually, Non-immunosuppressant medication involves the provision of antimalarial drugs such as Plaquenil, among others, to help in reducing the flare-ups of Lupus.
This can be combined with non-steroidal anti-inflammatory medicines such as NSAIDs, among others, to relieve children from stiffness as well as welling of affected areas. On the other hand, immunosuppressant medications involve the provision of corticosteroids such as prednisone, among others.
This is combined with disease-modifying anti-rheumatic drugs such as Methotrexate, among others. Moreover, other medications include biologics and cytotoxins (Habibi & Ramanan, 2012, p. 81-93).
Another form of treatment that can be carried out in patients with Juvenile SLE includes occupational/physical therapies, which may help to increase muscle strength and mobility. This is important, especially in children, as it enables them to do their day-to-day activities in manners that are relaxing to their bodies.
Moreover, counseling and psychotherapy may also be utilized to help reduce emotional and mental difficulties that may be experienced by patients suffering from chronic illnesses. It is also important that such patients change their lifestyles.
These include a change of diet (healthy diet), getting a lot of rest, controlling exposure to the sun, and staying active. These are important in helping children with juvenile SLE to stay active and to respond to medications (Habibi & Ramanan, 2012, p. 81-93).
Children with SLE have a higher risk of complications as compared to adults. Moreover, those diagnosed with illnesses requiring immunosuppressant drugs tend to have a weak immune system that can lead to infections.
Children with Juvenile SLE may also have complications with vital organs such as kidneys and brain. Other complications may include mobility in case physiotherapy is not done. In addition, exposure to sunshine may bring more problems as it causes skin rashes on patients with SLE.
There are several risk factors involved in SLE. These include environmental factors and well as genetically motivated factors. For instance, parents with SLE may pass it on to their children, although this is minimal. Other factors include exposure to sunshine, which has a high risk of worsening a patient’s condition.
Moreover, living lifestyle is also important in minimizing the disease. In essence, the main risk factors involved in SLE disease are genetics and the environment. These factors should be considered in the diagnosis of SLE.
Patients suffering from SLE are required to take healthy diets. This is important because studies show that the inflammatory process of juvenile SLE and autoimmunity are closely linked to the presence of obesity, metabolic syndrome, dyslipidemia, and systematic arterial hypertension.
In essence, a proper diet is, therefore, important to reduce such factors. Therefore, one should consider a diet with moderate energy content and protein. Moreover, the diet should be rich in minerals, fatty acids, and vitamins to help protect against the damage of body tissues. This is also helpful in suppressing inflammatory activities as well as in treatment (Klack, Bonfa & Ferreira, 2012, p. 1-5).
Lupus is a disease that affects the immune system of patients. The immune system can sometimes attack body tissues. This has the capacity to cause illnesses and damage to the affected tissues. This disease is more severe in children than in adults. Its diagnosis is usually overshadowed with complexities in order to come up with medications. People with Lupus need to have healthy lifestyles for a better quality of life.
El-Ghoneimy, D., Awad, Z. & Mostafa, G. (2012). CD4+CD25high T-Cells in Juvenile Lupus and Rheumatoid Arthritis. New York: LAP Lambert Academic Publishing AG & Co KG.
Habibi, S. & Ramanan, A. (2012). Review of Biologics in Children with Rheumatic Diseases: Juvenile Systemic Lupus Erythematosus. International Journal of Clinical Rheumatology, 7(1), 81-93.
International Autoimmune Arthritis Movement (2013). Juvenile SLE.
Klack, K., Bonfa, E., & Ferreira, E. (2012). Diet and nutritional aspects in systemic lupus erythematosus. Revista Brasileira de Reumatologia, 52(3), 1-5.
WebMD, LLC. (2013). Lupus Health Center.