Children and adolescents
Pediatric (childhood-onset) SLE
More severe than adult lupus, with higher rates of nephritis, cytopenias and neuropsychiatric disease.
What to look for
- Rash, arthritis, fever, oral ulcers, alopecia
- Cytopenias, proteinuria or hematuria, hypertension
- ANA positive in nearly all, with anti-dsDNA or anti-Sm and low complements
What to do
- Send ANA, anti-dsDNA, ENA, C3/C4, CBC, metabolic panel, urinalysis with microscopy, urine protein-to-creatinine ratio and BP.
- Kidney, lung, CNS or severe hematologic involvement is emergent. Coordinate with pediatric nephrology for nephritis.
- The 2025 ACR SLE guideline applies to children and adults.
About this urgency level
Early specialist assessment changes outcomes. Send the usual workup with the referral, but don't hold the referral while waiting for results.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.