Question

Paediatric SLE: Treatment.

Hint:

Pediatric SLE treatment aims to control inflammation, prevent damage to organs like the kidneys, and reduce flare-ups with appropriate immunosuppressive therapy.

Answer 1

Step 1: General Management of Pediatric SLE.
The treatment of pediatric SLE involves addressing the underlying disease, controlling inflammation, and preventing organ damage.
Step 2: Pharmacological Treatment.
(1) Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Used for pain and inflammation, especially in cases with mild arthritis or pleuritis.
(2) Hydroxychloroquine (Plaquenil): An antimalarial drug commonly used in SLE to reduce disease activity and prevent flares.
(3) Corticosteroids: Prednisone or other steroids are used to manage active disease, particularly in cases of severe flare-ups. The dose depends on the severity of organ involvement (e.g., kidney or CNS).
(4) Immunosuppressive Agents: For patients with severe disease or organ involvement, drugs such as azathioprine, cyclophosphamide, or mycophenolate mofetil are used to suppress the immune system and prevent damage.
(5) Biologic Agents: Belimumab (a monoclonal antibody) is used in certain cases of active SLE that do not respond to standard treatments.
Step 3: Supportive Management.
(1) Renal Support: In cases of lupus nephritis, medications such as mycophenolate mofetil or cyclophosphamide may be used, and dialysis may be required in severe cases.
(2) Vaccinations: Regular vaccinations are important as children with SLE are at increased risk of infections.
(3) Monitoring: Regular monitoring of kidney function, blood counts, and disease activity through laboratory tests.
Step 4: Long-term Care.
Long-term management involves preventing flares, managing chronic symptoms, and providing emotional and psychological support for the child and family.