Mosaic KRAS variants in childhood-onset systemic lupus erythematosus

Clinical targeted sequencing identified low-VAF KRAS variants in 2 of 26 children with childhood-onset systemic lupus erythematosus. Both children had severe inflammatory manifestations without Noonan syndrome features, and neither developed persistent lymphoproliferation suggestive of RAS-associated autoimmune lymphoproliferative disease during follow-up. The findings suggest KRAS mosaic mutations may influence the development or severity of childhood-onset SLE.