Children with lupus present with diverse and often severe manifestations. Children most frequently present with fever, fatigue, hematologic abnormalities, arthralgia or arthritis, rash, and renal disease. Symptoms may be intermittent or persistent.

Cutaneous manifestations are frequently present. The characteristic malar or butterfly rash involves the cheeks and nasal bridge and varies from an erythematous blush to thickened epidermis to scaly patches . Rashes may be photosensitive and extend to all sun-exposed areas.

Mucous membrane changes ranging from vasculitic erythema to ulcers occur, particularly on palatal and nasal mucosa.

Musculoskeletal findings include arthralgia, arthritis, tendinitis, and myositis. Deforming arthritis is unusual, although hand arthritis can lead to ligament damage and severely lax joints.

Serositis can affect pleural, pericardial, and peritoneal surfaces. Hepatosplenomegaly and lymphadenopathy are often found. Other gastrointestinal manifestations, most often resulting Continue reading »