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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. 1Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK
  2. 2Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  3. 3Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
  4. 4Translational 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

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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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