Paediatric Systemic Lupus Erythematosus with chronic diarrhea as an initial presentation

Area of Science:

• Pediatric Rheumatology
• Gastroenterology

Background:

• Childhood Systemic Lupus Erythematosus (cSLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Lupus enteritis (LE) is an uncommon gastrointestinal complication of cSLE, often presenting insidiously.

Observation:

• The patient presented with non-specific gastrointestinal symptoms, including loose motions, abdominal pain, nausea, and vomiting.
• Diagnosis of LE was challenging due to the absence of other typical cSLE features, requiring thorough investigation.
• The patient showed a positive response to initial management strategies.

Findings:

• Lupus enteritis is a rare but significant manifestation in pediatric patients with cSLE.
• Non-specific abdominal symptoms can be the sole presenting feature of LE, complicating early diagnosis.
• Prompt diagnosis and management are essential for mitigating severe complications.

Implications:

• Highlights the importance of considering LE in children with unexplained gastrointestinal issues, even without overt SLE signs.
• Emphasizes the potential for severe gastrointestinal complications like bleeding, perforation, and infarction in pediatric LE.
• Underscores that early intervention in LE leads to favorable outcomes and improved prognosis in children.