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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
PubMed

Insights

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.

Keywords:
Rheumatology/clinical immunologynephrologypathology

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