Delayed treatment leading to multisystem complications in a child with SLE

Background. Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder that can affect multiple organ systems. The disease is characterized by variability in its presentation and is unpredictable in its course and outcome. Children with the disease tend to have more severe manifestations and poorer outcomes compared to adults. Case report. We present the case of a 16-year-old female patient who had been symptomatic for 2 years with joint pain, recurrent fevers, alopecia, and oral ulcers, and was taking native herbal medications and undergoing acupuncture. She presented with multisystem involvement, including seizures, pericardial effusion, pancytopenia, hepatitis, arthritis, extensive cutaneous manifestations, neuropsychiatric symptoms, retinal vasculitis, and nephritis. Evaluation confirmed a diagnosis of SLE with class II nephritis. She was treated with steroids, intravenous immunoglobulin (IVIG), and rituximab. Her condition gradually improved with treatment, and she is currently on follow-up with good adherence. Conclusions. Delayed diagnosis can be associated with higher disease activity and organ damage in SLE. Clinical suspicion and early diagnosis pave the way for timely management, leading to better outcomes.