Systemic Lupus Erythematosus : yet another rare presentation

Abstract

A 14 year old girl was first seen at Karen Grech hospital for complaints of fainting attacks along with occasional convulsions and a progressive depressional state. She was seen by a psychiatrist who thought she had psychomotor retardation and was 'handicapped'. Concurrently, she had complaints of painful and stiff knees, ankles and wrist joints - especially during the morning hours. This went on for sixteen weeks during which period the girl's mental state deteriorated further with her having 'hysterical behaviour' at times, and suicidal tendencies. Her initial resentment of going to school increased and she had finally stopped going altogether for over a month when she was admitted into the Children's Ward with a'low grade pyrexia, mental confusion, deteriorating speech and difficulty in walking. She was a full term baby at birth with a normal delivery in a hospital in Malta. Birth weight 7 Ibs. She had no obstetric or neonatal problems and had suffered no significant illnesses in the past. She was never hospitalised before.