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Systemic lupus erythematosus in a black South African child. First documented case report
H M Coovadia1, A Hussain, L H Mwelase
1Department of Paediatrics and Child Health, University of Natal, Durban.
Insights
The first documented case of childhood Systemic Lupus Erythematosus (SLE) in a black South African child highlights this autoimmune disease
Area of Science:
- Pediatric Rheumatology
- Immunology
- African Health Sciences
Background:
- Systemic Lupus Erythematosus (SLE) is under-documented in African children.
- SLE prevalence varies by race and affects black adults more than white adults.
Observation:
- A 10-year-old black South African girl presented with classic SLE symptoms.
- Clinical manifestations included fever, rash, weight loss, neurological and renal involvement.
Findings:
- The patient exhibited C4 deposition, alopecia, lymphadenopathy, hepatomegaly, positive Coombs test, hypocomplementemia, anti-DNA antibodies, and anti-nuclear factor.
- Renal biopsy revealed WHO classification Vb membranous nephropathy.
- Central nervous system involvement included depression, withdrawal, and retinal exudates.
Implications:
- This case underscores the need for increased awareness and research into childhood SLE in Africa.
- Early diagnosis and management are crucial for improving outcomes in affected children.
- Further studies are needed to understand SLE's specific epidemiology and clinical spectrum in diverse pediatric populations.
Abstract:
Systemic lupus erythematosus (SLE) is poorly described among black children in Africa despite being more frequent among some black adult populations than their white counterparts. The first black South African child with SLE is documented. The patient was a 10-year-old girl who had fever, facial rash (with complement (C4) deposited at the dermo-epidermal junction of normal skin), weight loss, central nervous system involvement (depression, withdrawal, retinal exudates), renal involvement (glomerular filtration rate 54 ml/min/1.73 m2; membranous nephropathy with mild mesangial proliferation; World Health Organisation classification Vb), alopecia, lymphadenopathy, hepatomegaly, positive Coombs test, hypeocomplementaemia, anti-DNA antibodies and positive anti-nuclear factor.