Despite following the same basic recommendations as the adult guidelines, the pediatric LN guidelines included special considerations for younger patients.
The pediatric recommendations use the same classification criteria, outcome measures, and treatments as in adults — including the first-line triple therapy recommendation — but there remain important differences between pediatric and adult LN,, MD, clinical chief of immunology and section chief of rheumatology at Boston Children ’s Hospital and an associate professor of pediatrics at Harvard Medical School, Boston, told attendees.
Son also addressed differences in pediatric drug development. Dosing studies also do not always directly translate from adults to children because children have larger drug volume distribution and differences in drug clearance, and they may need different formulations, she said. Children tend to tolerate medications better than adults because they usually have fewer comorbidities, but the assessment of a drug’s safety must take its impact on growth and development into consideration.
“This is during a period of emerging self-identity and struggles with appearance; steroids exacerbate that” as well as mood issues already associated with puberty, Son said. “The transition from being a pediatric patient to being an adult patient is very challenging for a number of reasons,” starting with loss of insurance coverage, added, MD, a professor of internal medicine at UT Southwestern Medical Center in Dallas, Texas. When adult rheumatologists take on these patients, they may not have had care for 2 or 3 years, she said.
Systemic Lupus Erythaematosus SLE Systemic Lupus Erythematosus (SLE) Children Child Childhood Pediatrics Kids Clinical Guidelines Guidelines Lupus Nephritis Treatment Guidelines Lupus Glucocorticosteroids Glucocorticoid Therapy Glucocorticoid Toxicology Toxicity Poisoning Toxins Nephritis Steroids Adolescent Medicine Teens Teenage Teenager
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