Is your child constantly feeling unwell? Does their joints hurt? Does their face sometimes get red, butterfly-shaped rashes? If you have not just one or two of these symptoms, but several in a row, you may be worried. Today we are talking about a condition that can cause many of these symptoms to appear together, and is a bit complicated, but can be managed properly . That is lupus in children.
Simply put, what is lupus in these children?
Lupus is an autoimmune disease that can affect people of any age. Simply put, the main job of our immune system is to protect us from foreign invaders, such as germs and viruses that cause disease. But a person with lupus has a very unfortunate condition. This immune system goes awry. It starts to see its own healthy cells and tissues as "the enemy." It then starts attacking those healthy cells. It's like our own army attacking our own people instead of attacking foreign invaders.
When the disease is diagnosed before the age of 18, we call it "juvenile lupus." Lupus in children can be a little more severe than lupus in adults. This means:
- More active disease: Inflammation and related symptoms may be more noticeable.
- Increased risk of damage to internal organs: Vital organs, especially the kidneys, heart, lungs, and brain, can be affected.
- Need for more powerful treatment: The dose of medication may need to be increased.
- Side effects of long-term medication use: You should be aware of the possible side effects of taking medications, especially steroids (corticosteroids), for a long time.
The most common type of lupus in children is Systemic Lupus Erythematosus (SLE) . When someone says "lupus," they usually mean this type of SLE. It is also called `Childhood-onset SLE` or `Juvenile-onset SLE`. Symptoms usually begin to appear around the age of 12. However, they can start earlier or later. It is very rare for a child under the age of 5 to develop lupus.
The important thing is that even though this is a chronic disease, with proper treatment and management, the child can be given the opportunity to live a normal life. So, without fear, let's understand this properly.
What are the symptoms that suggest a child has lupus?
One of the unique things about lupus is that not every child has the same set of symptoms. Some people have one set of symptoms, while others have completely different ones. That's why doctors call this a "lupus fingerprint" - meaning that each person has a unique pattern of symptoms.
Let's divide these symptoms into two parts.
Symptoms that your child feels and you see
These are the things that you see and experience in your child's daily life.
| Symptom | A simple explanation |
|---|---|
| Butterfly Rash | A red rash appears on the child's cheeks and across the nose, like a butterfly spreading its wings. This is a very common symptom of lupus. |
| Joint pain and swelling (Arthritis) | Joints like fingers, wrists, and knees hurt and swell. This stiffness is worse when you wake up in the morning. |
| Fatigue | Feeling tired and sluggish all day, even after sleeping well. Feeling tired even after doing a little work. |
| Unexplained fever | It's not even a cold, just a fever. This fever can last for days. |
| Hair Loss | More hair loss than normal. Sometimes, the hair loss can be so severe that the scalp is visible in some places. |
| Mouth or nose sores | Small, painless sores inside the mouth or nose. |
| Weight loss | Without diet control, the child's body weight will decrease and they will become thin. |
These symptoms may appear gradually over time, or they may appear all at once. Remember, don't assume that your child has lupus just because they have one of these symptoms. For example, there could be thousands of other reasons for a fever. A doctor will suspect lupus when several of these symptoms appear together .
Signs revealed by medical tests
These are the things that can be found through tests performed by the doctor, especially blood and urine tests.
- Decreased number of blood cells:
- Decreased red blood cells (anemia)
- Low platelet count (thrombocytopenia)
- Decreased white blood cells (leukopenia)
- Antinuclear Antibodies (ANA): This type of antibody called `ANA` is often seen in the blood of children with lupus. However, a `positive` ANA test does not necessarily mean that you have lupus. Healthy people can also sometimes be `positive`. Therefore, your doctor will explain to you what the report means.
What are the possible complications of lupus?
Proper treatment can greatly reduce the risk of these complications, but some children may still develop these conditions.
- Kidney damage (Lupus Nephritis): This is the most serious complication in children. The immune system attacks the kidneys, which can lead to kidney failure. The child may have symptoms such as swollen legs and foamy urine due to protein in the urine.
- Lung and heart effects: Inflammation of the lining of the lungs (pleurisy) or inflammation of the sac around the heart (pericarditis) can occur. Both conditions can cause sharp chest pain .
- Central nervous system effects: If the brain and spinal cord are affected, conditions such as severe headaches, behavioral changes, and seizures can occur.
- Blood clots: Blood clots can form inside the blood vessels, especially in the legs. Symptoms include pain, swelling, and redness in the affected leg.
Why do children get lupus?
There is no single, specific cause for this yet, but researchers believe it is caused by a combination of factors.
1. Genetics: If someone in the family has lupus or another autoimmune disease, the child may also have a slight predisposition to developing the disease. However, having those genes does not necessarily mean that they will develop lupus.
2. Environmental Triggers: A child with a genetic predisposition may develop the disease due to an external trigger. Such triggers include:
- A viral infection
- Exposure to strong sunlight (UVA/UVB rays)
- Hormonal changes (especially during puberty)
To put it simply, genes are like a gun loaded with gunpowder. But without someone to pull the trigger (a trigger), the bullet won't go off. Lupus is like that.
How does a doctor diagnose this disease?
Diagnosing lupus is a complicated process because there is no single test that is specific to it. The doctor will combine several factors to arrive at a diagnosis.
- Talking to yourself and your child: Ask your child in detail about their symptoms, such as when they started and how long they have been present.
- Performing a complete physical examination: Checking for skin lesions, joint swelling, and mouth sores.
- Blood and urine tests: As mentioned earlier, these tests check many things, such as the `ANA` test, blood cell count, and kidney function.
- Family history: Ask if anyone in the family has lupus or similar diseases.
It is after considering all of this that the doctor decides whether or not you have lupus.
What are the treatments for lupus?
There is currently no cure for lupus. But don't worry. There are many effective treatments that can help control the disease and help your child live a normal life. The main goals of treatment are:
- Reducing the child's symptoms.
- Stopping the immune system from damaging the body's organs.
- Maintaining the child's overall physical and mental health at a good level.
A team of specialists comes together to develop a treatment plan that is tailored to the child. This team may include a pediatric rheumatologist , nurses, physical therapists, and mental health professionals.
There are several main types of medications used:
- Corticosteroids: For example, a drug called `Prednisone`. These quickly control inflammation in the body.
- Hydroxychloroquine: Although this is a drug for malaria, it is very helpful in controlling lupus flares.
- Immunosuppressants: These medications work by slowing down the overactive immune system. Drugs like `Azathioprine`, `Mycophenolate mofetil`, `Methotrexate` fall into this category.
- Painkillers: Medicines like `Ibuprofen` or `Naproxen` can be given for joint pain.
- Calcium and vitamin D: These are given to prevent osteoporosis, as there is a risk of bone thinning when taking steroids for a long time.
Important: It is essential to give your child the medicine prescribed by the doctor exactly as prescribed, at the correct time, and in the correct dosage. Never stop taking the medicine or change the dosage on your own.
Let's also be aware of the side effects of treatments.
Like all medications, lupus medications can have side effects. The doctor is always aware of this and performs the necessary tests during treatment.
- Prednisone (steroid): Long-term use can cause weight gain, stretch marks, high blood pressure, thinning bones, depression, diabetes, and cataracts.
- Hydroxychloroquine: Very rarely, it can cause damage to the retina of the eye. Therefore, all children taking this medication should have their eyes checked regularly by an ophthalmologist.
- Immunosuppressants: These medications can lower white blood cell counts and cause liver inflammation. They also lower immunity, increasing the risk of infections. Therefore, regular blood tests are done to check for these.
How can I, as a parent, help my child?
Your contribution to this journey is priceless. There are many things you can do to provide the best care for your child.
1. Protect from the sun: Sunlight is a major trigger for lupus. Therefore, apply sunscreen with SPF 30 or higher to your child's skin every day. This should be done even on cloudy days. Wear a hat and long-sleeved clothing when going outside. Minimize exposure to strong sunlight between 10:00 a.m. and 4:00 p.m.
2. Provide adequate sleep: Fatigue is a major symptom of lupus. Therefore, create an environment that allows your child to sleep well.
3. Protect against infections: Since the child is taking medications that suppress the immune system, he is more likely to catch diseases. Teach him to wash his hands with soap and water frequently. Keep him away from people who are sick.
4. A healthy lifestyle: It is important to provide a balanced diet and engage in age-appropriate exercise. Exercise strengthens muscles. But if your child is tired, let them rest.
5. Teach your child about the disease: Explain the disease to your child in a simple way that is appropriate for their age and understanding. This will help them take responsibility for their own body.
6. Provide emotional support: Living with a chronic illness can be emotionally difficult for a child. Allow them to talk about their feelings, let them vent their sadness, and let their anger out. If necessary, seek the help of a counselor.
7. Inform the school: Inform the teachers and administration of the child's school about this situation and provide the necessary facilities.
Don't forget, to take care of your baby, you need to stay healthy too . Eat, drink, and rest on time. If you're feeling mentally tired, talk to your doctor or someone you trust about it.
Take-Home Message
- Lupus is an autoimmune disease in which the body's immune system attacks its own healthy cells.
- Lupus in children can be more severe than in adults and is more likely to cause damage to internal organs.
- The main symptoms are a "butterfly" rash on the face, joint pain, constant fatigue, and unexplained fever.
- Although this cannot be completely cured, very effective treatments can control the disease and allow the child to live a normal life.
- It is essential to protect yourself from the sun, take your medication properly, and follow your doctor's instructions.
- If you have any doubts or questions, contact your child's doctor immediately and talk about it.
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