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A 4-year old presenting with fever and achiness
Caroline Plott1, Thomas Gracie1, Courtney Alvis2
1Johns Hopkins School of Medicine, Baltimore, MD, USA.
SAGE Open Medical Case Reports
|November 4, 2021
Summary
Diagnosing multi-system disease in young children is difficult. This case highlights pediatric systemic lupus erythematosus presenting with lupus nephritis in a 4-year-old girl.
Area of Science:
- Pediatric Rheumatology
- Nephrology
- Systemic Autoimmune Diseases
Background:
- Diagnosing multisystem diseases in children under 5 presents significant challenges.
- Early-onset systemic lupus erythematosus (EOSLE) requires careful evaluation of diverse clinical and laboratory findings.
Observation:
- A 4-year-old girl exhibited behavioral changes, fever, arthralgia, arthritis, and hematuria.
- Previous hospitalizations for pneumonia and impetigo complicated the initial diagnostic process.
Findings:
- Serologic tests suggested a rheumatologic cause.
- Renal biopsy confirmed Membranous Lupus Nephritis Class V, leading to a diagnosis of pediatric systemic lupus erythematosus.
Implications:
- This case underscores the importance of considering EOSLE in young children with unexplained multisystem symptoms.
- Understanding the clinical features and diagnostic criteria for EOSLE is crucial for timely diagnosis and management.
- Early diagnosis of pediatric lupus nephritis can improve patient prognosis.
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