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Such a serious diffuse connective tissue disease as lupus in children develops as a result of a malfunction of the immune system. This is due to a genetic factor in which pathological processes occur in all internal organs and systems.
The disease in children is not so common, on average 1 case per 100 children is recorded and mainly in adolescent girls aged 000-12 years.
Causes of lupus in children
Of great importance in the development of the disease is the hereditary factor. It has been noted that systemic lupus erythematosus occurs much more often in identical twins and to a lesser extent in fraternal twins. In a child with a predisposition to the occurrence of systemic lupus erythematosus, various external factors can serve as an impetus for development – insolation, viral infectious diseases, prolonged hypothermia, vaccination, or psycho-emotional trauma. As a result of their impact, the body begins to produce antibodies to its own tissues, which leads to the defeat of all organs and systems. In the absence of proper treatment, the disease often leads to the death of the patient.
The clinical picture of lupus in children
Systemic lupus erythematosus in children is characterized by a more severe and rapid course. In this case, almost the entire body is affected – the pathological process covers the skin, musculoskeletal system, heart, kidneys, lungs; the nervous system is also affected.
The most frequent and early manifestations of the disease are rashes on exposed skin. The most characteristic feature is the “lupus butterfly”, localized in the cheekbones and back of the nose. Often, lupus erythematosus in a child is accompanied by hair loss up to complete baldness. For the acute period in children, damage to the red border of the lips, mucous membranes of the oral cavity with the development of aphthous stomatitis is typical.
A rash appears on open parts of the body, especially bright after exposure to the open sun. The severity of the vascular pattern on the thighs, legs, in the region of the forearms is noted. Hemorrhagic and petechial rashes may appear on the skin of the trunk and extremities – typical manifestations of vasculitis.
Almost all children with lupus erythematosus affect the joints, which manifests itself in the form of arthralgia and arthritis, often accompanied by pain. Predominantly small joints of the hands, wrists and ankles suffer – the deformity is accompanied by muscle atrophy.
As a rule, complications from the cardiovascular system in children are manifested in the form of myocarditis, myopericarditis. In almost half of the cases, there is a simultaneous lesion of all three membranes of the heart – pancarditis.
On the part of the respiratory system in children, lupus pneumonitis is most often diagnosed, which is mostly asymptomatic, and signs of lung damage are either practically not detected or absent at all.
Meningoencephalitis is a characteristic sign of involvement in the process of the central and peripheral nervous system. It is manifested by asthenovegetative syndrome, polyneuritis, emotional disorders, sometimes accompanied by delusional states, visual or auditory hallucinations, epileptic seizures.
Lupus nephritis in children is very difficult, in the most dangerous, nephrotic form. Edema develops up to anasarca, the child’s blood pressure rises, in the urine tests, the indicators of protein and erythrocytes increase. In the blood, the level of creatinine and urea rises sharply. The most dangerous lupus nephritis is the development of renal failure.
Diagnosis of lupus in a child
When making a diagnosis, the data of a medical examination, the results of a laboratory and instrumental examination are taken into account. A decisive role is played by an immunological study, which makes it possible to determine the signs characteristic of lupus. As additional examination methods, standard tests are prescribed: general, biochemical and clinical blood tests, urinalysis. To identify complications, diagnostics are carried out according to indications: ultrasound of the heart, electrocardiogram, coagulogram, examination of the abdominal organs, kidneys, brain and spinal cord, electromyography.
Treatment of lupus in children
Systemic lupus erythematosus is a disease that, without adequate and ongoing treatment, can be fatal. Treatment, as a rule, complex therapy, should be carried out in specialized institutions under the supervision of a rheumatologist in close contact with the local pediatrician.
Sick children are recommended a special regimen, most require individual homeschooling and an additional day off. It is strictly contraindicated to carry out vaccinations, taking certain medications. The child needs a calm, harmonious environment, you need to try to protect him from stress and psycho-emotional trauma.
How is lupus transmitted?
The causes of the disease have not yet been precisely established. It is believed that lupus can be contagious and spread from person to person, but the route and mode of transmission has not been confirmed or elucidated. As a result of laboratory experiments and experiments, not a single version of the origin and spread of the disease has been confirmed accurately enough.