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Child having auto inflammatory disorder. What is causing the peeling sores on tongue?

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Practicing since : 1999
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Good evening. We have a ten year old son who has some sort of autoimmune disorder. At this point, it is being called Auto Inflammatory Disorder-Not Otherwise Specified With Lupus-Like Symptoms. He gets joint pain, Gross hematuria, especially with illness, HUGE canker sores, a "butterfly" rash with sun exposure or fatigue, gross fatigue, fragile and ridged nails, especially toe nails. Lately, though, he is getting HUGE sores on his tongue that look like the first few layers of tissue have been scrapped off. They are painful. It is worse with acidic food,but they are sometimes there without acidic food. Can Juvenile Lupus cause these large, peeling sores on the tongue?
Posted Sun, 25 Nov 2012 in Lupus
Answered by Dr. Divya Agarwal 1 hour later
Thanks for sharing your concern with us
Since Lupus can have varied manifestations, it is possible that the sores on the tongue are due to lupus.
However, does he have a positive ANA? As that decides whether he has Lupus or one of the auto inflammatory syndromes.
I am sure you are already in touch with a pediatric rheumatologist, because if he is on proper treatment his problems should gradually subside.

The other possibility is that his symptoms are being caused by fungal or herpes infection but this is definitely less likely.
I hope I have been helpful.
Get back to me in case of any further doubts.
Above answer was peer-reviewed by
Follow-up: Child having auto inflammatory disorder. What is causing the peeling sores on tongue? 13 hours later
Thank you! He has had positive ANAs in the past, the first one was when he was 4. But, he is now on Celebrex and Plaquenil, and they have not been duplicated since. He has many of the other symptoms, though, as well. There is a bit of an argument between his various docs... Rheum doesn't think it is Lupus while his Derm, Pain, and Immunology are thinking it is more likely. But, since he doesn't have a current +ANA, Rheum doesn't think so. But, they did admit that the Plaquenil use could be masking it. He is an anomaly, for sure. Every few months, something new pops up. He used to get HUGE canker-type sores in his mouth between his teeth and lips and his bottom lip often splits and bleeds, but these have lessened since the Plaquenil was started. But, the malar rash with sun exposure and the tongue sores are new as of this summer. Thanks for your help!
Answered by Dr. Divya Agarwal 9 hours later

If he has had positive ANAs in the past then Lupus is a definite possibility.

The good thing is that he does not have major organ involvement like CNS and kidney.

Plaquenil is good, but if his problems are persisting then some other immunosuppressant may be added to keep the disease in remission, like mycophenolate mofetil.

I think a thought should be given to that.

In addition, of course avoidance of sun and sunscreen is a must.

I hope things come under control.

Above answer was peer-reviewed by
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