Establishment of a Multidisciplinary Pediatric Lupus Care Clinic at a Tertiary Center

Esra Meidan,1,* Ankana Daga,2,* Amy Mcdonough,1 Maria Biancarelli,3 Caitlyn M Dorsey,1 Anthony Dekermanji,3 Brittany Esty,1 Mary Beth Son,1 Melissa Hazen1 1Division of Immunology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA; 2Division of Nephrology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA; 3Department of Pediatrics, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA*These authors contributed equally to this workCorrespondence: Ankana Daga, Division of Nephrology, Boston Children’s Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA, Tel +1 617-355-6129, Email [email protected]: Childhood-onset systemic lupus erythematosus (cSLE) is a complex autoimmune disease marked by higher disease severity, multi-organ involvement, and a greater risk of kidney damage compared to adult-onset SLE. Recognizing the challenges associated with treating cSLE, especially in patients with lupus nephritis, Boston Children’s Hospital established a multidisciplinary pediatric lupus clinic. This clinic integrates rheumatology, nephrology, nursing, and social work services to provide comprehensive, coordinated care. The team-based model facilitates shared decision-making, personalized treatment plans, and proactive management of social determinants of health. The average SLEDAI-2K score improved in this lupus clinic patient population. Clinic follow-up rates were 100% and patient ER visits and inpatient admissions of this high-risk patient population were low (15% and 4%). Despite challenges related to team formation, practice standardization, and financial sustainability, the clinic has demonstrated success in improving care delivery. Future goals include expanding trainee involvement, piloting quality improvement measures, and using the clinic as a model for broader cSLE care. This approach offers a promising framework for equitable, high-quality care for pediatric lupus patients.Keywords: pediatric lupus, childhood onset SLE, childhood-onset systemic lupus erythematosus, lupus nephritis, multidisciplinary care