LUPUS HEADACHES IN 55 CHILDHOOD-ONSET SLE:

Objective: Although headache is a common complaint among patients with lupus, no universally accepted explanation was available until International Headaches Society adopted Lupus Nomenclature in it's classification recently. Few studies indicate that lupus patients with positive ANA and positive antiphospholipid antibodies (aPL) experience more frequent headaches. To determine correlation between headache frequencies and ANA and aPL positivity, we conducted this study.

Methods: This prospective multicenter study enrolled 55 children with lupus who have been followed up for 5 years, aged 3–16 years (mean11.5years), 45 girls and 10 boys (F/M ratio: 4.5) complaining from headache. Whether lupus headache is a sign of progressive nature of disease, and how it should be best treated is not still clear. Those with active disease, hypertension, tension headache were not included in this study.

Results: We reviewed 55 children with lupus. After the children were diagnosed with lupus, lupus headaches occurred especially early in the course of the disease. Twenty three (43%) of our patients developed new or significantly worse, persistent headaches that sometimes were similar to migraines. However their headache was not accompanied with disease flare up and the headaches were not found to be related to hypertension or use of other medications too. We came to diagnosis of lupus headache for these patients. From those (29%) had positive aPL and ANA titer.

Conclusion: Lupus headaches are most likely multifactorial, and probably only a small proportion of them truly represent active lupus. More research is required to find better treatments and developing tests that can help physicians to identify those with lupus headaches who are at risk for developing permanent damage.

Keywords: Lupus, Headache, Antiphospholipid antibody, children