Holland MJ, et al. - Authors sought to describe the frequency and types of disease damage occurring with childhood-onset systemic lupus erythematosus (SLE) as measured by the 41-item Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). They prospectively collected the information for the SDI from 1,048 childhood-onset SLE patients. They also evaluated the SDI's ability to reflect damage severity. In childhood-onset SLE, even with relatively short disease durations, disease damage as measured by the SDI is common. A requirement to develop new tools to estimate the impact of childhood-onset SLE–associated damage was seen in view of the shortcomings of the SDI.