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Systemic lupus erythematosus in children: a case report and review
A D Kemiki1, S Jimmy, A Rongap
1Modilon (Madang) General Hospital, Madang Province, Papua New Guinea.
Insights
A pediatric case of systemic lupus erythematosus (SLE) in Papua New Guinea highlights the potential for rapid, fatal multisystemic progression. Early diagnosis and consistent follow-up are crucial for managing this severe autoimmune disease in children.
Area of Science:
- Pediatric Rheumatology
- Autoimmune Diseases
- Clinical Case Study
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Pediatric SLE often presents with nonspecific symptoms, posing diagnostic challenges.
- Geographic variations in SLE presentation and outcomes are increasingly recognized.
Observation:
- A 12-year-old female in Papua New Guinea presented with fever and anemia, progressing to multisystem involvement.
- The disease affected respiratory, gastrointestinal, central nervous, musculoskeletal, and cutaneous systems.
- The patient was diagnosed with SLE and initiated on treatment.
Findings:
- Despite initial treatment, the patient defaulted from follow-up after seven months.
- She rapidly developed acute respiratory distress and succumbed within 24 hours.
- This case underscores the aggressive potential of SLE in pediatric populations, particularly with treatment interruption.
Implications:
- Highlights the critical need for adherence to treatment and regular follow-up in pediatric SLE.
- Emphasizes the importance of considering SLE in children presenting with unexplained fevers and multisystemic symptoms.
- Suggests a need for improved access to specialized care and patient education in resource-limited settings for better SLE management outcomes.
Abstract:
A 12-year-old Papua New Guinean female presented initially with nonspecific clinical symptoms, fever of unknown origin and anaemia. She subsequently developed multisystem disease involving the respiratory, gastrointestinal, central nervous, musculoskeletal and cutaneous systems. She was diagnosed to have systemic lupus erythromatosus (SLE) and started on treatment. Unfortunately the patient defaulted from follow-up after treatment, which covered seven months only, to present with acute respiratory distress from which she died within 24 hours. A relevant literature review with the clinical features of systemic lupus erythematosus in children is described.