An Unusual Presentation of Juvenile Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems that often mimic other conditions. The majority of patients with SLE show mucocutaneous manifestations, fatigue, fever, rheumatological manifestations, and weight loss as initial symptoms. SLE is classically managed medically with hydroxychloroquine, glucocorticoids, and/or immunosuppressives. Juvenile-onset systemic lupus erythematosus (jSLE) patients, who account for about 20% of SLE patients, tend to have earlier development of end-organ damage, and increased need for immunosuppressive therapies. We present a 12-year-old woman with a history of atopic conditions who initially presented for treatment of mild gastritis and a duodenal ulcer diagnosed by esophagogastroduodenoscopy (EGD). Several months later, the patient developed hematological abnormalities and rashes classically associated with SLE. Healthcare providers need to be aware of the distinct features of jSLE and modalities of treatment.