Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease with 
highest prevalence among women of childbearing age. However, children younger 
than 16 years also can develop SLE (childhood-onset lupus/juvenile-type SLE). 
The aim of our study was to compare the clinical course of adult and 
pediatric-onset SLE. Data from 342 adult patients followed at the University of 
Debrecen, Hungary, and 79 children documented in the Hungarian National 
Pediatric SLE registry were analyzed using hospital medical records. Organ 
manifestations, laboratory parameters, and immunoserological characteristics 
were reviewed and the results were evaluated using SPSS for Windows 
software.Gender distribution was not significantly different between groups with 
disease starting in childhood vs adulthood. The prevalence of the following 
manifestations was significantly higher for pediatric than for adult-onset 
disease including: lupus nephritis (43% pediatric vs 26.4% for adult-onset), 
hematological disorders (57% vs 36.4%), photosensitivity (20% vs 9%), butterfly 
rash (61% vs 35.5%) and mucosal ulceration (11.4% vs 4%). For adult-onset SLE, 
neurological symptoms (30% vs 6%) and polyarthritis (86% vs 68%) occurred 
significantly more frequently than in children. Anti-SSA, anti-SSB and 
antiphospholipid antibodies were detected at significantly higher levels in 
adult-onset patients compared to those in pediatrics. Children were more 
commonly given high-dose intravenous immunoglobulin treatment (6.3% vs 0.6%) and 
mycophenolate mofetil (15.2% vs 5.3%) than adults.These results suggest that 
pediatric and adult-onset SLE differ in multiple aspects, and it is important to 
recognize these differences for optimal treatment and prognosis of these 
patients.