This website uses cookies to give you the best experience. By continuing to use this website you are consenting to cookies being used. You can delete and block cookies from within your browsers settings. For more information please refer to our privacy and cookie policy page.


Juvenile Systemic Lupus Erythematosus

Juvenile Systemic Lupus Erythematosus (JSLE) is rare but is more common in non-caucasians, with a predominance of girls affected in the adolescent group and a more equal sex distribution in young children.

The arthritis of JSLE is usually polyarticular, often the pain is the major symptom but there is little objective swelling. 

The photograph below shows a malar rash (which can be photosensitive) in JSLE - typically this spares the nasolabial folds and helps differentiate from other rashes such as acne)

Extra - articular features are variable, and a diagnosis of JSLE is made with a combination of clinical and laboratory features (which are summarised below). 

Common presenting symptoms of JSLE:

  • Skin - Malar rash (photosensitivity), Alopecia, vasculitis rashes, Raynaud ’s phenomenon.
  • Arthritis - polyarticular (small joints mainly).
  • Systemic features - Fatigue / Fever / Weight loss / Oral ulcers.
  • Pleuritis/pericarditis.
  • Central nervous system (e.g., headaches, seizures, psychosis).
  • Lymphadenopathy.
  • Hepatosplenomegaly.
  • Hypertension, peripheral oedema, facial puffiness (periorbital oedema).

Laboratory findings:

  • Anaemia (may be haemolytic with positive red cell autoantibodies).
  • Leukopaenia, lymphopaenia, thrombocytopaenia.
  • Elevated liver enzymes.
  • Elevated kidney function tests (blood urea nitrogen, creatinine).
  • Abnormal urinary sediment.
  • Decreased complement components C3 and C4.
  • Positive antinuclear antibody (ANA).
  • High titre positive anti-double stranded (ds) DNA antibody.
  • Other positive autoantibodies  (anti-Ro (SSA); anti-La (SSB); anti-Sm; anti-RNP).
  • Positive anti-phospholipid antibodies (anti-cardiolipin, lupus anticoagulant).

Drug - induced JSLE can develop from the use of anti-convulsants, oral contraceptives or minocycline.

The medical management of JSLE is complex and requires specialist supervision, with nearly all patients requiring corticosteroid and immunosuppressive medications

In addition, patients often require anti-hypertensives, anti-coagulation (related to anti-phospholipid syndrome), and medications to control dyslipidaemias and avoid osteoporosis (e.g., calcium & vitamin D).

The photograph below shows mouth ulcers of the palate and also skin changes of JSLE.


The two photographs below shows skin vasculitis in JSLE.

The photograph below shows diffuse alopecia in JSLE.

Site Statistics

To date (end of December 2021) PMM has >984,153 hits and >410,366 users from 221 countries!

Why register?

Some parts of pmm which involve pictures or videos of children, can only be viewed by registered users. Registering also allows you to bookmark favourite pages and track your viewing.

find out more

Short online courses

from Newcastle University, UK

e-resources from PMM

pmm for you

Please help us ensure pmm is as useful to you as possible by completing this short survey

complete survey