Despite the insight into SLE patients HRQOL, further study is needed to confirm or clarify results in many areas [36].
Research has demonstrated that additional support and interventions are needed to reduce the symptom load in SLE patients and improve their HRQOL [37]. This is particularly important for pediatric cases, which comprise 15-20% of SLE patients [38,39J. and can be significant during their transition to adult rheumatology care [40]. The enormous psychological and social impact of the disease and its treatments upon the child or young person and their family necessitates a comprehensive, holistic, specialized multidisciplinary approach [41]. Indeed, a specialized disease rating scale had been developed, the Simple Measure of Impact of Lupus Erythematous in Youngsters scale, which was validated by a multicenter cross sectional study of children and adolescents 5-18 years of age with SLE in Brazil [42]. Future studies should therefore include pediatric SLE patients.