Case number 5 : systemic lupus erythematosus (SLE)

Abstract

Ms. YM, a 16-year-old girl, presented to A&E with a 1 week history of progressive, bilateral, and symmetrical lower limb weakness and lethargy. She was also complaining of decreased sensation in her lower limbs and an itchy erythematous rash on the palms of her hands. A couple of weeks prior to this she had been admitted to hospital and treated for pericarditis and chest infection. Neurological examination revealed inconsistency in all muscle groups, and giveaway weakness. The patient was also noted to have abnormal behaviour. Bilateral palmar erythema and multiple splinter haemorrhages were observed. With these clinical features and the investigations carried out systemic lupus erythematosus could be diagnosed and the appropriate treatment was started. The patient will be followed up at Rheumatology, Neurology, and Ophthalmology Outpatients, with physiotherapy for rehabilitation.