Systemic lupus erythematosus — RACP Paediatrics MCQ

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HardRheumatology and dermatologySystemic lupus erythematosusRACP Paediatrics

A 13-year-old girl has fatigue, photosensitive rash, oral ulcers and swollen small joints. Urinalysis shows blood and protein, complement C3 is low and ANA is strongly positive. What is the most likely diagnosis?

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Correct answer: D — Systemic lupus erythematosus

Multisystem disease with photosensitive rash, oral ulcers, arthritis, nephritic urine, low complement and positive ANA supports systemic lupus erythematosus. Juvenile idiopathic arthritis does not usually cause low complement or nephritis at presentation. Renal involvement must be assessed promptly because it drives prognosis and treatment intensity.

Reference: RACP Knowledge Guides; Australian paediatric rheumatology guidance