%0 Journal Article
%T Pediatric patient with systemic lupus erythematosus & congenital acquired immunodeficiency syndrome: An unusual case and a review of the literature
%A Elizabeth C Chalom
%A Fariba Rezaee
%A Joel Mendelson
%J Pediatric Rheumatology
%D 2008
%I BioMed Central
%R 10.1186/1546-0096-6-7
%X The coexistence of HIV in patients with lupus is extremely rare, especially in the pediatric population. Case reports generally describe patients with HIV who subsequently develop rheumatologic complaints. In children, there have only been five reported pediatric cases of SLE and HIV [1-4]. In all of five, the children had known congenital HIV and then developed SLE. In four of those cases, the child developed lupus nephritis, but no other clinical manifestation of SLE [1-3]. The fifth was a case report of lupus vasculitis without nephritis in a child with congenital HIV [4]. The case we are presenting is exceedingly rare among pediatric cases and we could not find a similar one in the literature. Our patient first presented with SLE and subsequently showed the manifestations of congenital human immunodeficiency syndrome.Patient was a 9 year old African American female who presented with fevers, polyarthritis, and morning stiffness. She had no rash or significant adenopathy. Her height was at the 25th percentile for age and her weight was just below the 50th percentile. Laboratory investigations revealed WBC = 2,800 cells/mm3 (58% neutrophils, 38% lymphocytes), hemoglobin = 10.4 g/dL, platelets = 167,000/mm3, erythrocyte sedimentation rate(ESR) = 56 mm/h, ANA titer = 1:1280, C4 complement <10 mg/dl, and anti-double stranded DNA (dsDNA) = 1051 IU/ml. Urinalysis was within normal limits. She was diagnosed with SLE and treated with prednisone, naproxen, and hydroxycholoroquine Over the next ten months, the prednisone was tapered and discontinued. The naproxen was later changed to rofecoxib and she did well on a combination rofecoxib and hydroxychloroquine for two years. She was then lost to follow-up for 13 months and did not take her medications. She then returned, complaining of arthralgias. She had no arthritis on exam and laboratory studies showed anemia with a hemoglobin of 9.9, WBC = 2.1 cells/mm3 (51%neutrophils, 23% lymphocytes, 21% monocytes and 5% basophils)
%U http://www.ped-rheum.com/content/6/1/7