A 4-year old presenting with fever and achiness. (October 2021)

• Record Type: Journal Article
• Authors: Plott, Caroline; Gracie, Thomas; Alvis, Courtney; Schlefman, Amanda; Dudas, Robert
• Is Part Of: SAGE open medical case reports. Volume 9(2021)
• Publication Date: 2021-10
• Subjects: Rheumatology/clinical immunology -- pathology -- nephrology; Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1177/2050313X211056416
• Languages: English
• ISSNs: 2050-313X

Abstract

In children under the age of 5 who have abnormalities in history, physical examination, and laboratory studies indicating multi-system disease, uncovering the correct diagnosis is challenging. Here, we report the course of a 4-year-old girl who presented with a change in behavior, fever, arthralgia, arthritis, and hematuria following three recent hospitalizations for pneumonia and impetigo. Serologic findings were suggestive of a rheumatologic etiology and a renal biopsy was consistent with Membranous Lupus Nephritis Class V which helped secure the diagnosis of pediatric systemic lupus erythematosus. We review the clinical features and diagnostic criteria of early-onset systemic lupus erythematosus and discuss diagnostic considerations and prognosis.