Chronic autoimmune urticaria as the first manifestation of juvenile systemic lupus erythematosus
Lupus,

Spadoni MS et al. – Chronic autoimmune urticaria is very rare and may be the first lupus manifestation, particularly associated with the presence of autoantibodies. This study reinforces the importance of a rigorous follow–up in children and adolescents suffering from autoimmune urticaria due to the possibility of connective tissue disorders, such as paediatric lupus.

Methods
  • During 27 consecutive years, 5419 patients were followed up at the University Hospital and 271 (5%) had juvenile SLE (American College of Rheumatology criteria).

Results
  • Two of them (0.7%) had chronic and painless autoimmune urticaria as the first manifestation of juvenile SLE, and were reported herein.
  • One case was a five–year old female with continuous widespread urticaria (duration 120 days), antinuclear antibodies (ANA) 1:640 (dense fine speckled pattern) and elevated complement levels.
  • The juvenile SLE diagnosis was established after one year.
  • The other case was a 13–year old female who had chronic widespread urticaria (lasting 45 days), ANA 1:160 (fine speckled pattern) and normal complement levels.
  • The juvenile SLE diagnosis was established after three years.

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