Le lupus de l'enfant à travers les âges = Systemic lupus erythematosus through the ages

Pediatric lupus is the prototype of systemic autoimmune disease in children as well, and is associated with multi-organ involvement, autoantibody production, and often a severe course. It usually has its onset during adolescence, but can occur in young children as well (in which case, rare genetic forms have to be searched). Pediatric lupus is characterized by a high frequency of renal involvement. The disease severity requires an early diagnosis for early treatment, in order to control inflammation and avoid life-threatening complications. Medical therapy consists in a pharmacologic approach with immunosuppressive drugs, as well as in a multidisciplinary approach that takes into account the growth and development of the child with his/her special needs. Neonatal lupus is a different disorder, secondary to the transplacental passage of anti-SSA/Ro and anti-SSB/La maternal autoantibodies. Prognosis depends on cardiac involvement that can often be a third-degree atrio-ventricular block (which is irreversible and needs pacemaker implantation). Other minor clinical manifestations (cutaneous, hematological, hepatic involvements) usually spontaneously disappear, concomitantly with maternal autoantibody clearance.