About 25,000 children in the United States have lupus or a related disorder. A chronic autoimmune condition, lupus can cause a wide range of symptoms, ranging from mild to severe.
While lupus doesn’t have a cure, it can be managed.
Find out more about how lupus affects kids, including symptoms, diagnosis, and treatment.
What Is Lupus?
Lupus is an autoimmune disease. It causes the immune system to attack other parts of the body, including:
- Internal organs.
- Mucous membranes (the lining of some organs and body cavities).
Most lupus diagnoses happen during adulthood. But according to the American Academy of Pediatrics (AAP), childhood-onset lupus accounts for as many as 20% of overall cases. Childhood-onset diagnosis typically happens at age 10 and up.
Depending on the child, symptoms can be mild to severe and life-threatening.
Types of Lupus
There are four major types of lupus:
- Systemic lupus is most common. It usually affects a major organ or tissue in the body, like your heart, lungs, kidneys, or brain.
- Cutaneous lupus affects the skin.
- Drug-induced lupus occurs when you receive certain medications for a prolonged period of time. Symptoms often lessen or go away when you stop using the medication.
- Neonatal lupus is rare and happens when a mother’s antibodies affect an unborn fetus. The baby may have symptoms as a newborn, but they often go away in the first year of life. The exception is a type of heart block that requires close monitoring as the baby grows.
Lupus Causes and Risk Factors
There is no known cause of lupus. Environmental factors, genetics, and hormones all may play a part in someone getting lupus.
However, certain people are more at risk for lupus than others:
- Females. According to the Lupus Foundation of America, 90% of people living with lupus are women. The disease typically develops between the ages of 15 and 44. Males can get the disease, too, though — and a higher proportion of male children get the disease compared to male adults.
- Non-Caucasians. Black, Hispanic, Asian American, Native American, Alaska Native, Native Hawaiian, and Pacific Islander communities are all at greater risk of lupus than whites.
- People with a family history. Genetics may play a role in who gets lupus, but it is complex. There is not just one “lupus gene” that may cause lupus, but research is underway to learn more.
Pediatric Lupus Symptoms
Lupus affects each person differently. Some children may have mild symptoms. Others may have more severe symptoms.
Lupus is often more aggressive in children. The disease most often affects the organs, skin, or joints. According to the Lupus Foundation of America, children diagnosed with lupus are more likely to have kidney or neurological damage than people diagnosed as adults.
Common symptoms of lupus in kids include:
- A malar rash across the bridge of the nose and on the cheeks (also known as a “butterfly rash” because of its shape) that gets worse after sun exposure.
- Weight loss.
- Unexplained fevers.
- Bald spots/hair loss.
- Memory loss.
- Concentration problems.
- Mouth or nose sores.
- Joint pain or swelling.
- Muscle aches.
- Shortness of breath.
- Chest pain.
Lupus can cause other complications, including kidney problems, blood clots, and inflammation in the brain or spine. These complications also can cause symptoms like fluid retention, headaches, leg swelling, and seizures.
Symptoms may come and go early on, but often become more persistent if undiagnosed or untreated. Certain environmental triggers can cause lupus symptoms or make them worse. These may include sunlight, fluorescent light, fatigue, stress, cigarette smoke, and more. There are no known food or diet triggers for lupus in children. If you know of something that triggers your child’s symptoms, it’s important to avoid it.
How Is Lupus Diagnosed?
Because lupus can affect many different parts of the body, it’s not always easy to diagnose. Your child’s pediatrician will ask about symptoms, perform a physical exam, and run tests to help diagnose the condition.
Blood tests, urine tests, and biopsies can show indicators that can diagnose or confirm that your child has lupus.
Is Lupus Treatable?
There is no cure for lupus at this time. But treatment has advanced over the years and can help manage symptoms and prevent serious complications.
Your provider might recommend that your child see a pediatric rheumatologist. Depending on their symptoms, they also may see other pediatric specialists, including nephrologists (kidneys), dermatologists (skin), ophthalmologists (eyes), cardiologists (heart), and pulmonologists (lungs).
Disease management may include:
- Taking medications, including anti-inflammatories, antimalarials, steroids, immunosuppressants, and others.
- Avoiding sunlight and fluorescent light and wearing high-SPF sunscreen and protective clothing when out in the sun.
- Doing exercises to help with muscle and joint pain.
- Eating a healthy, well-balanced diet. This is important for general growth and development in all children, including children with lupus. There is no special “anti-inflammatory” or “immune” diet a child should follow.
- Avoiding infections.
You can help your child manage the disease by staying up to date on visits with their pediatrician and other specialists. You also should recognize your child’s triggers and try to avoid them as much as possible.
The Division of Pediatric Rheumatology at UPMC Children’s Hospital of Pittsburgh can help diagnose and treat kids with lupus. For more information or to schedule an appointment, visit our website.