Systemic Lupus Erythematosus — RACP Paediatrics MCQ

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ModerateRheumatologySystemic Lupus ErythematosusRACP Paediatrics

An 11-year-old girl presents with a malar rash, oral ulcers, arthritis, and proteinuria. ANA is positive at 1:640, anti-dsDNA antibodies are elevated, and complement C3 and C4 are low. What is the most likely diagnosis?

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Correct answer: A — Systemic lupus erythematosus

Systemic lupus erythematosus (SLE) in children presents with multisystem involvement including a malar ('butterfly') rash, oral ulcers, arthritis, and renal disease (proteinuria). Characteristic laboratory findings include positive ANA, elevated anti-dsDNA antibodies, and low complement (C3 and C4). Renal involvement (lupus nephritis) is a major determinant of prognosis and should be assessed with a renal biopsy.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Systemic Lupus Erythematosus