From the Guidelines
Pediatric Systemic Lupus Erythematosus (SLE) management should prioritize reducing morbidity, mortality, and improving quality of life, with a focus on early recognition and treatment of organ involvement, particularly lupus nephritis. Here are four multiple-choice questions on pediatric lupus:
- Question 1: Which laboratory finding is most specific for diagnosing pediatric systemic lupus erythematosus (SLE)? A) Positive anti-nuclear antibody (ANA) B) Positive anti-double stranded DNA (anti-dsDNA) antibody C) Leukopenia D) Elevated erythrocyte sedimentation rate. The correct answer is B, as anti-dsDNA antibodies are more specific for SLE diagnosis, although ANA is sensitive (present in >95% of cases) 1.
- Question 2: Which medication is considered first-line for managing mild to moderate pediatric lupus? A) Cyclophosphamide B) Hydroxychloroquine C) Rituximab D) Azathioprine. The correct answer is B, as Hydroxychloroquine (5-7 mg/kg/day, maximum 400 mg daily) is recommended for virtually all pediatric lupus patients, reducing flares, damage accrual, and mortality 1.
- Question 3: Which organ involvement in pediatric lupus necessitates immediate aggressive immunosuppression with cyclophosphamide or mycophenolate mofetil? A) Arthritis B) Mild rash C) Nephritis D) Mild thrombocytopenia. The correct answer is C, as lupus nephritis, especially proliferative forms (Class III/IV), requires prompt treatment with induction therapy using cyclophosphamide (500-1000 mg/m² monthly) or mycophenolate mofetil (600 mg/m² twice daily) plus corticosteroids 1.
- Question 4: Which complication is more common in pediatric-onset lupus compared to adult-onset disease? A) Nephritis B) Neuropsychiatric manifestations C) Photosensitivity D) Sjögren's syndrome. The correct answer is A, as lupus nephritis occurs in approximately 50-75% of pediatric lupus patients, a significantly higher rate than in adult-onset disease, contributing to higher disease severity in children 1.
From the Research
Multiple-Choice Questions Regarding Pediatric Systemic Lupus Erythematosus (SLE)
- What is the typical female to male ratio in pediatric SLE patients, according to the study by 2?
- A) 1:1
- B) 3.8:1
- C) 6.2:1
- D) 10:1
- Which of the following is the most common renal manifestation in pediatric SLE, as reported in the study by 2?
- A) Hematuria
- B) Proteinuria
- C) Nephrotic syndrome
- D) Renal failure
- What is the primary outcome measured in the Pediatric Lupus Nephritis Mycophenolate Mofetil (PLUMM) study, as described in 3?
- A) Complete renal response (CRR) at week 26
- B) Partial clinical remission of LN (partial renal response, PRR) at week 26
- C) Reduction in SLEDAI score
- D) Improvement in quality of life
- Which treatment has been shown to be effective and safe in treating severe pediatric SLE, according to the study by 4?
- A) Rituximab
- B) Mycophenolate mofetil
- C) Corticosteroids
- D) Cyclophosphamide