Unmasking Lupus: Chorea as the Sole Initial Manifestation

Systemic lupus erythematosus (SLE) is an autoimmune disease with a wide spectrum of clinical manifestations, including neuropsychiatric systemic lupus erythematosus (NPSLE). Although a recognized feature of NPSLE, Chorea is an uncommon initial presentation, particularly in children. We report the case of a 12-year-old girl who presented with acute generalized chorea as the first manifestation of SLE. Extensive evaluation, including clinical, laboratory, and imaging studies, confirmed the diagnosis of SLE and identified neuropsychiatric involvement. This case underscores the importance of considering SLE in the differential diagnosis of pediatric chorea and highlights the diagnostic and therapeutic challenges in managing NPSLE with chorea as the primary feature.