ESPE Abstracts (2014) 82 P-D-3-3-650

Coexistence of Unusual and Distinctive Initial Clinical Manifestations of Systemic Lupus Erythematosus (SLE): a Child Case Presentation and Evaluation of Polyglandular Autoimmune Syndrome in SLE

Murat Karaoglan, Mehmet Keskin, Sibel Öztürk & Ozlem Kesin

Gaziantep Medical Faculty, Gaziantep, Turkey

Background: Involvement of multiple spesific endocrine organs in systemic lupus erythematosus (SLE), as initial manifestations, are quite rare. These manifestations can appear singly or combined. But they have been usually reported singly. We report a child case who coexists many of rare clinical features of SLE at the same time at onset.

Objective and hypotheses: Polyglanduler autoimmune syndrome may be a part of SLE. Coexistence of many polyglanduler autoimmune diseases as initial manifestations at onset is extremely rare. In that instance, to make diagnosis can be very difficult.

Method: A 3.5-year-old boy was diagnosed with adrenal insuffiency and treated with hydrocortisone at Children’s Hospital of City about 1 year ago. The patient was admitted to our department with history abdominal pain, abdominal distantion, and irritability. Physical examination on admission was unremarkable except for massive hepatomegaly, abdominal distantion, and photosensitivity. Further investigations showed a patient who represents quite rare features of SLE.

Results: Any autoimmune disorder can involve any endocrine organ. Any autommune disorder can contribute or trigger another autoimmune disorder. SLE can concomitant with polyglanduler autoimmune syndrome.

Conclusion: The initial manifestations of chlidhood-onset SLE are miscellaneous and serious. Therefore, if any autoimmune endocrine disease with unexpected manifestations was described in any child patient, SLE should be urgently investigated.

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