Lupus eritematoso sistemico a esordio con embolia polmonare

A 15-year-old girl was hospitalized with persistent fever lasting 40 days, accompanied by fatigue, loss of appetite and muscle pain. After initial antibiotic treatment proved ineffective, further investigations revealed pulmonary embolism and cardiac involvement. Positive ANA, along with leukopenia, anaemia and proteinuria, led to the diagnosis of systemic lupus erythematosus (SLE) based on EULAR criteria. Treatment with corticosteroids and hydroxychloroquine improved her clinical condition. This case highlights the variability of SLE, which may present with thrombotic manifestations even in the absence of antiphospholipid antibodies.