A clinical update on paediatric lupus

Systemic lupus erythematosus in children is a life-threatening chronic disease that is being increasingly recognised. More black Africanchildren are being diagnosed and the proportion of males affected is much higher than in adult-onset lupus. The presenting manifestationsof childhood-onset lupus are variable and many systems are involved. Children with lupus often present late with severe disease, and inSouth African (SA) children severe lupus nephritis occurs commonly at presentation. The investigations for lupus should be performed ina three-step process – initial essential investigations, antibody and serological tests, and supplementary investigations.The most important factor in the management is to involve a multidisciplinary team as soon as possible. All cases of lupus in SA should be discussedwith a paediatric specialist so that a tailored management plan can be made, depending on the presenting features and course of the disease