Neuropsychiatric lupus: An uncommon presentation of pediatric systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease with a variety of clinical manifestations and several immune-mediated abnormalities leading to multiple organ dysfunction. In adult-onset SLE, neurological symptoms and polyarthritis predominate, whereas in children and adolescents, lupus nephritis, hematological disorders, photosensitivity, butterfly rash, and mucosal ulceration are more common. We describe the case of a 16-year-old boy presenting with fever, rash, seizures, ultimately diagnosed with neuropsychiatric lupus. Laboratory findings, including positive autoantibodies and neuroimaging suggestive of central nervous system involvement, supported the diagnosis. Treatment comprised steroids, cyclophosphamide, and adjunctive therapy, leading to clinical amelioration. Neuropsychiatric SLE management focuses on symptomatic relief and halting underlying disease processes, often requiring immunosuppressive therapy. This case underscores the varied clinical spectrum of childhood SLE and highlights the pivotal role of steroids and cyclophosphamide in managing neuropsychiatric manifestations.