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Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Testing for the Evaluation of Musculoskeletal Complaints in Pediatric Populations

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Background: Pediatric Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an episodic, multisystem, autoimmune disease characterized by widespread inflammation of blood vessels, connective tissues, and organs. It is estimated that the incidence of pediatric SLE (pSLE) is 0.3 to 0.9 per 100,000 children per year and the prevalence is 3.3 to 8.8 per 100,000. The onset of pSLE is rare before 5 years of age and uncommon before adolescence, after which the rates of occurrence stabilize. The diagnosis of pSLE is generally based on the classification criteria of the American College of Rheumatology, which include specific signs, symptoms, and laboratory test results such as a positive antinuclear antibody test (see Appendix A in the report). Left untreated, pSLE is often progressive and can be fatal. As awareness of pSLE has increased, early diagnosis has become more common, and rapid introduction of effective immunosuppressive treatment has led to improved outcomes.