Pediatric Rheumatology
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 Case ReportRhupus arthropathy as the presenting manifestation in Juvenile SLE: a case reportErbil Unsal  , Ayse Ozgun Arlı  and Hakkı Akman Dokuz Eylul University, Faculty of Medicine, Department of Pediatrics, Division of Immunology-Rheumatology, Balcova 35340 Izmir, Turkiye  author email corresponding author email
Pediatric Rheumatology 2007,
5:7doi:10.1186/1546-0096-5-7 Abstract
An 8.5-year-old girl was referred with swelling of both knees lasting for two years. ANA was found as negative. She was diagnosed as oligoarticular JIA. After two years of follow-up, thrombocytopenia was detected during routine screening. Her ANA and anti ds-DNA antibodies also became positive, with low levels of C3 and C4. She was diagnosed as Juvenile SLE, meeting the criteria cytopenia, positive immunoserology (anti dsDNA), positive ANA test, and four years of ongoing chronic arthritis, so called as "rhupus arthropathy". We should be aware of the several initial incomplete presentations of lupus in children. We should be careful in monitoring the serious manifestations of the disease in juvenile lupus patients with rhupus arthropathy, and consider the poor response to standard disease modifying agents. | 
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