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Guideline review
Diagnosis and treatment of childhood-onset systemic lupus erythematosus (European evidence-based recommendations from the SHARE initiative)
  1. Eve M D Smith1,2,
  2. Ethan Sukumar Sen3,4,
  3. Clare E Pain2
  1. 1 Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK
  2. 2 Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  3. 3 Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
  4. 4 Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  1. Correspondence to Dr Eve M D Smith, Department of Women’s and Children’s Health, University of Liverpool, Liverpool L12 2AP, UK; esmith8{at}liverpool.ac.uk

https://doi.org/10.1136/archdischild-2017-314049

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    Background

    In 2013, the European Union-funded Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) project was initiated to produce consensus evidence-based international guidance for the diagnosis and management of paediatric rheumatic diseases. The need for this stemmed from observations of varying practice between clinicians/centres throughout Europe as a result of the rarity of paediatric rheumatic diseases, and the challenges in undertaking clinical research.

    Childhood-onset systemic lupus erythematosus (cSLE, also known as juvenile or paediatric SLE) is a rare, multisystem autoimmune disease with potential for significant associated morbidity and mortality. The SHARE recommendations for its diagnosis and treatment were published in June 20171 (box 1).

    Box 1

    Resources

    Background on the Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative:

    • Wulffraat NM, Vastert B; SHARE consortium. Time to share. Pediatr Rheumatol Online J 2013;11:5.

    • European Union (EU) projects database: http://ec.europa.eu/chafea/projects/database/database_new.inc.data.20111202.pdf.

    SHARE childhood-onset systemic lupus erythematosus (cSLE) recommendations:

    • European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative. http://ard.bmj.com/content/76/11/1788.

    • European evidence-based recommendations for the diagnosis and treatment of childhood-onset lupus nephritis: the SHARE initiative. http://ard.bmj.com/content/76/12/1965.

    • European evidence-based recommendations for diagnosis and treatment of paediatric antiphospholipid syndrome: the SHARE initiative. http://ard.bmj.com/content/76/10/1637.

    SHARE recommendations for other paediatric rheumatic diseases:

    • Consensus-based recommendations for the management of juvenile dermatomyositis. http://ard.bmj.com/content/76/2/329.

    • Evidence-based recommendations for genetic diagnosis of familial Mediterranean fever. http://ard.bmj.com/content/74/4/635.

    • Ter Haar NM, Oswald M, Jeyaratnam J, et al. Recommendations for the management of autoinflammatory diseases. http://ard.bmj.com/content/74/9/1636.

    • Recommendations for collaborative paediatric research including biobanking in Europe: a Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative. http://ard.bmj.com/content/early/2017/10/11/annrheumdis-2017-211904.

    Previous guidelines

    No previous guidelines or recommendations on the diagnosis and management of cSLE exist. Adult SLE literature2 3 was consulted where there was no evidence in children.

    Key issues that the guideline addresses

    A total of 25 recommendations were …

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    Footnotes

    • Contributors EMDS, ESS and CEP all participated in conception and design of this manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.