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having SLE The proposed scoring system is currently being studied to see in what way the sensitivity and specificity compares to the ACR and SLICC classification systems More research is needed to determine if the EULAR/ACR classification system is applicable for diagnosing SLE in children It is probable that in the future, this new classification will replace the 1997 ACR and 2012 SLICC classification systems FIGURE 101.2 Mucosal lesions (macules and ulcers) of the palate in an adolescent girl with active lupus Goals of Treatment SLE is often more severe in children than in adults Although adult lupus patients are more likely to die of complications, children and adolescents with lupus are more likely to succumb earlier, during the acute stages of the disease Common causes of death within the first years of diagnosis are pancreatitis, pulmonary hemorrhage, infection, thromboembolic disease, and active neuropsychiatric disease Delayed diagnosis and treatment are strong risk factors for morbidity and mortality in pediatric lupus In view of the fact that cumulative disease activity over time correlates with damage from the disease, expedient diagnosis and appropriately aggressive treatment is particularly critical for children Thus, pediatricians need to maintain a high index of suspicion for lupus, and physicians experienced in the care of children with SLE should participate in the diagnosis and management of all pediatric lupus patients Clinical Considerations Clinical Recognition