OBJECTIVETo discuss the differences in the clinical features, laboratory tests and renal pathology between children and adults with systemic lupus erythematosus (SLE).

METHODSA retrospective study was performed in 198 children and 200 adults with SLE.

RESULTSFever, rash, arthritis, anemia and renal involvement were the most common symptoms in both groups. The incidence of hepatomegaly, splenomegaly, lymphadenectasis, anemia, renal involvement, nervous system involvement and digestive apparatus involvement were higher in children with SLE. The mean SLE Disease Activity Index score was also higher in the children. Immunological findings showed that a greater proportion of children with SLE were positive for anti-double stranded DNA antibody, anticardiolipin antibody and perinuclear antineutrophil cytoplasmic antibody. Renal pathological examinations showed that children with SLE patients were more likely to have serious renal involvement. The misdiagnosis rate was higher in children with SLE patients. During the hospital stay, 12 (6.1%) children with SLE died, with an average disease course of 6.8 months; 9 (4.5%) adults with SLE died with an average disease course of 4.2 years.

CONCLUSIONChildren with SLE patients are liable to have systemic involvement and higher misdiagnosis rate, often with poorer prognosis than the adult patients.