One hundred and seventy patients with rheumatological disease diagnosed before their 16th birthday and still on follow up were studied retrospectively. They were seen within the last 3 years at KK Women's and Children's Hospital, Tan Tock Seng Hospital, National Skin Centre or Singapore General Hospital. Of these, 89 were still less than 16 years old at the time of study. The majority had
systemic lupus erythematosus (51.8%). Many were on long-term follow-up for persistent disease, including renal manifestations (47.7%),
neurological manifestations (26.1%) and
haemolytic anaemia (15.9%). Photosensitivity and
malar rash were more common than in Western studies while
arthritis was less common. Anti-
phospholipid antibodies were found in children complicated by
myocardial infarction,
pulmonary hypertension, Raynaud's phenomenon, cerebral and gut lupus. Children with
juvenile chronic arthritis comprised 28.8% and
juvenile dermatomyositis 10%. The male predominance and lack of
uveitis in children with pauciarticular JCA were striking. Rarer conditions included
polyarteritis nodosa, scleroderma,
rheumatic fever with
arthritis, polychondritis and
Behcet's disease. Many diseases may first present with a rheumatological complaint. This review of features of local children highlights similarities and differences with Western data. It also provides information for planning
long-term care, multidisciplinary clinics,
group physiotherapy sessions, educational programmes and support groups.