Question

Paediatric SLE: Diagnostic criteria.

Hint:

The classification criteria help in confirming the diagnosis of pediatric SLE but clinical judgment remains essential, especially in early disease.

Answer 1

Step 1: Diagnostic Criteria for Pediatric SLE.
The diagnosis of pediatric SLE is based on the classification criteria established by the American College of Rheumatology (ACR) and the Systemic Lupus International Collaborating Clinics (SLIC. Common criteria include:
(1) Malar Rash – A butterfly-shaped rash across the cheeks and nose.
(2) Discoid Rash – Round, scaly, erythematous lesions with scarring.
(3) Photosensitivity – Exacerbation of rashes or symptoms due to sun exposure.
(4) Oral Ulcers – Painless sores inside the mouth.
(5) Arthritis – Swelling and pain in two or more joints.
(6) Serositis – Inflammation of the lining of the heart or lungs, often presenting as pleuritis or pericarditis.
(7) Renal Involvement – Proteinuria or hematuria, often a hallmark of lupus nephritis.
(8) Positive ANA – Found in the majority of patients.
(9) Anti-dsDNA or Anti-Smith Antibodies – Highly specific for SLE.
The diagnosis of pediatric SLE is often made when at least 4 of the above criteria are met, with at least one being clinical (e.g., rash, arthritis) and one being immunological (e.g., positive ANA, anti-dsDN.