Abstract:
Background and Aims: Systemic Lupus Erythematosus (SLE) in children is a rare but severe autoimmune disease with a higher rate of organ involvement and complications compared to adults. Metabolic emergencies as the initial or concurrent presentation of pediatric SLE are uncommon and may delay diagnosis. This report aims to highlight a rare pediatric case of SLE presenting with multiple simultaneous metabolic crises and to emphasize the importance of early recognition and multidisciplinary management.
Methods: We describe a detailed clinical case of a 6-year-old child admitted with acute metabolic derangements. Clinical findings, laboratory investigations, imaging studies, and immunological workup were reviewed systematically. Diagnosis was established based on clinical features and immunological criteria consistent with pediatric SLE.
Results: The patient presented with diabetic ketoacidosis, severe hyperlipidemia, acute pancreatitis, hypertension, Cushingoid features, and lupus nephritis. Laboratory investigations revealed autoimmune activity, metabolic imbalance, and renal involvement. Early initiation of immunosuppressive therapy, metabolic correction, and supportive intensive care resulted in gradual clinical and biochemical improvement.
Conclusions: Pediatric SLE may rarely present with multiple life-threatening metabolic crises simultaneously. A high index of suspicion, prompt investigation, and coordinated multidisciplinary management are essential to improve outcomes and reduce morbidity in such complex presentations.
