How is lupus diagnosed in children?
The first step for every family is to be sure the diagnosis is correct. Lupus is a highly variable disease. Some children have obvious lupus symptoms with fever, rash, and kidney involvement. Others may only complain of not feeling well, or of being tired or achy. Some children look fine, but have blood in their urine or other unseen problems that lead their physicians to make the diagnosis of lupus. Although a positive ANA is generally required to make the diagnosis, there are many children with positive ANAs who do not have lupus. Most physicians rely on the American College of Rheumatology (ACR) criteria for the diagnosis of definite lupus. It is important to be aware of these. However, some physicians assume anyone who does not fulfill four of the criteria could not have lupus. Especially in children, it is important to remember that more problems may develop over time. If you have questions about your child’s diagnosis you can contact your local chapter of the Lupus Foundation of America (LFA) for a list of experienced doctors in your area.
Once the diagnosis is established parents are immediately concerned about what will happen to their child. While lupus can be a severe and life-threatening disease, many children with lupus will do very well. The prognosis of lupus in childhood depends on the severity of the internal organ involvement. Children with significant kidney or other internal organ disease require aggressive treatment. Children with mild rash and arthritis may be easily controlled. However, lupus is unpredictable and no one will be able to predict with certainty the long-term outcome for a specific child.
Medically reviewed on August 16, 2013