CLINICAL PRESENTATION OF SLE
Sujata Sawhney*
Consultant Pediatric and Adolescent Rheumatologist Center for Child Health Sir Ganga Ram Hospital, New Delhi.*
Systemic lupus erythematosus (SLE) is an autoimmune disorder, the diagnosis of which is clinical and is supported by specific laboratory abnormalities.

The word Lupus is derived from the Latin word for Wolf. It was used in medicine from the thirteenth to the nineteenth century to describe a skin disorder characterized by facial ulceration. Kaposi first described the skin disease of lupus in 1872. William Osler in 1895 was the first to recognize the systemic nature of the disorder. Libman and Sacks described the cardiac involvement in 1924. In 1935 Klemperer, Behar and Schifrin first put the clinical features of SLE, as known today.

SLE is a multi-system disease that is caused by tissue damage resulting from antibody and complement fixing immune complex deposition. There is a wide spectrum of clinical presentation, and the disease is characterized by remissions and exacerbations. In 1997 revised criteria for SLE were put forward. These criteria are 96% sensitive and specific.

Important clinical features that should alert the treating physician to the possibility of SLE as an underlying diagnosis are:
  1. Fever with fatigue and arthralgia
  2. The presence of arthritis with serositis
  3. The combination of skin and joint disease
  4. Unexplained glomerulonephritis
  5. Unexplained neurological signs
  6. Multisystem disorder
  7. Anemia with leukopenia and fever, where leukemia has been excluded

This is a primer about SLE in children, and it is to introduce the reader to this topic.
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