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  • Juvenile-onset systemic lupus erythematosus with multisystem involvement complicated by posterior reversible encephalopathy syndrome (PRES)

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Rheumatology
Juvenile-onset systemic lupus erythematosus with multisystem involvement complicated by posterior reversible encephalopathy syndrome (PRES)
  1. Erika Cefai1,
  2. Daniela Grima2,
  3. Valerie Said Conti2 and
  4. Cecilia Mercieca1
  1. 1Rheumatology, Mater Dei Hospital, Msida, Malta
  2. 2Paediatrics, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Erika Cefai; Erika.carachi{at}gov.mt

Abstract

A previously healthy girl in her middle childhood of African origin presented with a 2-week history of fever and sore throat. Initial tests showed pancytopenia and proteinuria while the septic screen was negative except for the presence of parvovirus B19 infection. When her symptoms persisted, the possibility of an underlying connective tissue disorder such as systemic lupus erythematosus (SLE) was explored and confirmed. Despite the initiation of glucocorticoids, she went on to develop renal and neuropsychiatric involvement which only responded to high-dose immunosuppression including plasma exchange. This case demonstrates the aggressiveness and rapidity of organ involvement in juvenile-onset SLE and the need for timely appropriate immunosuppression and treatment escalation.

  • Connective tissue disease
  • Systemic lupus erythematosus
  • Proteinurea
  • Epilepsy and seizures

https://doi.org/10.1136/bcr-2024-260733

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    Footnotes

    • X @erika_Cefai

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: EC and CM. The following authors gave the final approval of the manuscript: DG and VSC. EC is the guarantor. Is the patient one of the authors of this manuscript? No.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.