Ramia Dalati Alhashimi

NMC Royal Hospital,
UAE

Abstract Title: A Rare Presentation of Paediatric Systemic Lupus Erythematosus

Biography:

Research Interest: Patient Information: ● Age: 9 years 11 months ● Gender: Female Presenting Complaint: The child presented to the Emergency Department with high fever, shivering, vomiting, and cough—symptoms that had started two days prior. Notably, she had been hospitalized two weeks earlier for fever and was diagnosed with adenovirus, mycoplasma, and positive Widal test findings. Despite an initial four-day hospitalization and apparent recovery, her fever returned with increasing severity. Clinical Course & History: ● Persistent fever spikes exceeding 40°C, accompanied by heavy cough and abdominal pain. ● Mild, intermittent fever continued between the two hospital admissions. ● Previous antibiotic treatments from local medical centers failed to improve her condition. ● Fever worsened in frequency and severity before the second admission. ● Parents reported that symptoms began after consuming sweets containing milk, eggs, and sugar from outside the UAE Diagnosis & Treatment: Despite initial concerns about infections (positive Widal test, adenovirus, and mycoplasma), further investigations revealed: ● Significantly elevated autoimmune markers (ANA, Anti-SS, Anti-SM antibodies) ● High ESR (83) and leukopenia The diagnosis of Systemic Lupus Erythematosus (SLE) was confirmed. The child responded excellently to Hydroxychloroquine and oral Prednisolone, leading to a remarkable clinical improvement. Challenges Faced: ● Confounding positive infections (typhoid markers, adenovirus, and mycoplasma) initially masked the underlying autoimmune disorder. ● Delayed diagnostic confirmation due to the time required for SLE-specific tests. ● Parental counseling—explaining persistent fever despite IV antibiotics—but the parents’ cooperation and trust in the medical team played a crucial role in achieving the correct diagnosis and treatment. Key Takeaways: ● Pediatric SLE should be considered in cases of prolonged fever with unexplained multisystem involvement. ● Autoimmune disorders can mimic infectious illnesses, making diagnosis challenging. ● A multidisciplinary, team-based approach is essential for accurate diagnosis and optimal patient outcomes. This case highlights the importance of vigilance in paediatric autoimmune conditions and the power of teamwork in achieving timely and life-changing diagnoses