2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43
Lupus in a child (children)
Such a serious diffuse connective tissue disease like lupus in children develops as a result of a dysfunction of the immune system. This is due to a genetic factor in which pathological processes occur in all internal organs and systems.
The disease in children is not so common, with an average of 1 case per 100,000 children and mainly in adolescent girls aged 12-14 years.
Causes of Lupus in Children
The hereditary factor plays a great role in the development of the disease. It has been noticed that much more often systemic lupus erythematosus occurs in identical twins and, to a lesser extent, in fraternal twins. In a child with a predisposition to the occurrence of systemic lupus erythematosus, various external factors can serve as an impetus for development - insolation, viral infectious diseases, prolonged hypothermia, vaccination or psycho-emotional trauma. As a result of their influence, the body begins to produce antibodies to its own tissues, which leads to damage to all organs and systems. In the absence of proper treatment, the disease often leads to the death of the patient.
The clinical picture of lupus in children
Systemic lupus erythematosus in children is characterized by a more severe and rapid course. In this case, almost the entire body is affected - the pathological process covers the skin, musculoskeletal system, heart, kidneys, lungs; the nervous system is also affected.
The most common and early manifestations of the disease are rashes on open skin areas. The most characteristic feature is the lupus butterfly, localized in the cheekbones and nasal dorsum. Often, lupus erythematosus in a child is accompanied by hair loss up to complete baldness. For the acute period in children, typical lesions of the red border of the lips, mucous membranes of the oral cavity with the development of aphthous stomatitis.
A rash appears on open areas of the body, especially bright after exposure to the open sun. The severity of the vascular pattern on the thighs, legs, in the area of the forearms is noted. Hemorrhagic and petechial rashes may appear on the skin of the trunk and extremities - typical manifestations of vasculitis.
In almost all children with lupus erythematosus, joints are affected, which manifests itself in the form of arthralgias and arthritis, which are often accompanied by pain. It is mainly the small joints of the hands, wrist and ankle joints that are affected - the deformation is accompanied by muscle atrophy.
As a rule, complications from the cardiovascular system in children are manifested in the form of myocarditis, myopericarditis. In almost half of the cases, there is a simultaneous defeat of all three membranes of the heart - pancarditis.
On the part of the respiratory system, children are most often diagnosed with lupus pneumonitis, which are mostly asymptomatic, and signs of lung damage are either practically undetectable or absent at all.
Meningoencephalitis is a characteristic sign of involvement of the central and peripheral nervous system in the process. It manifests itself as asthenovegetative syndrome, polyneuritis, emotional disorders, sometimes accompanied by delusional states, visual or auditory hallucinations, and epileptic seizures.
Lupus nephritis in children is very difficult, in the most dangerous, nephrotic form. Edema develops up to the anasarca, the child's blood pressure rises, and the indicators of protein and erythrocytes grow in urine tests. In the blood, the level of creatinine and urea rises sharply. The most dangerous lupus nephritis is the development of renal failure.
Diagnosis of lupus in a child
When making a diagnosis, the data of a medical examination, the results of laboratory and instrumental examination are taken into account. An immunological study plays a decisive role in determining the characteristics characteristic of lupus. As additional methods of examination, standard tests are prescribed: general, biochemical and clinical blood tests, urinalysis. To identify complications, diagnostics are carried out according to the indications: ultrasound of the heart, electrocardiogram, coagulogram, examination of the abdominal cavity organs, kidneys, brain and spinal cord, electromyography.
Treatment for lupus in children
Systemic lupus erythematosus is a disease that can be fatal without adequate and permanent treatment. Treatment, usually complex therapy, should be carried out in specialized institutions under the supervision of a rheumatologist in close contact with a local pediatrician. A special regimen is recommended for sick children; most require individual home education and an extra day off. Vaccinations, taking certain medications are categorically contraindicated. The child needs a calm, harmonious environment, you need to try to protect him from stress and psycho-emotional trauma.
How is lupus spread?
The causes of the disease have not yet been established precisely. It is believed that lupus can be contagious and spread from person to person, but the route and mode of transmission has not been confirmed or elucidated. As a result of laboratory experiments and experiments, not a single advanced version of the occurrence and spread of the disease has been confirmed accurately enough.
The author of the article: Sokolova Praskovya Fedorovna | Pediatrician
Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.
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