Juvenile systemic lupus erythematosus with primary neuropsychiatric presentation

Systemic lupus erythematosus (SLE) is an autoimmune disease-causing inflammatory tissue damage with multiple organ involvement. We report a 12-year-old girl who presented with 6-month history of high-grade intermittent fever and weight loss, psychiatric symptoms beginning 10 days before admission, and generalized tonic–clonic seizure 4 days before admission to our hospital. Investigation excluded infectious etiology. Immunological workup revealed high titer of antinuclear and anti-double-stranded DNA antibodies. She was treated with steroids and azathioprine and responded well to treatment. It is important to have a very high index of suspicion for the diagnosis of SLE for early diagnosis, treatment, and meticulous monitoring.