TY - JOUR T1 - The management of lupus in young people JF - British Journal of General Practice JO - Br J Gen Pract SP - 96 LP - 97 DO - 10.3399/bjgp18X694805 VL - 68 IS - 667 AU - George McGill AU - Nicola Ambrose Y1 - 2018/02/01 UR - http://bjgp.org/content/68/667/96.abstract N2 - Juvenile onset systemic lupus erythematosus (JSLE) accounts for 20% of all SLE presentations. It most commonly develops around adolescence. It is a serious and complex autoimmune disease that, although requiring specialist care, will benefit from the active involvement of general practice.JSLE is a chronic autoimmune disease that can affect any part of the body including skin, joints, and the major organs. It most commonly presents around adolescence (median age at diagnosis 12–14 years). The female preponderance is less marked in adolescents than in adults.1JSLE patients have a more aggressive disease than adults. They have higher rates of organ involvement including renal and liver disease, are more likely to die in the acute phase of the illness, and sustain more organ damage. In contrast with some juvenile arthritis patients, JSLE patients do not ‘grow out’ of the disease. They will therefore have a lengthy disease duration and incur a great burden of medication and its unwanted effects.JSLE patients are still about 18 times more likely to die than their peers (standardised mortality rate [SMR] JSLE 18.3, confidence interval [CI] = 11.8 to 28.3), in contrast with adults (SMR 3.1, CI = 2.6 to 3.9).1 Deaths usually relate to active JSLE with organ involvement, often in the context of suboptimal treatment adherence. Counselling patients with organ involvement about the controllable but serious nature of the illness is difficult but essential.JSLE symptoms are highly variable from a relatively mild disease such as a rash with joint pains and fatigue, to a … ER -