Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 7, Núm. 14 (Ed. Esp.

Diciembre 2024) ISSN: 2737-6273

Clinical Presentationand Managementof Vasculitis in an Adolescentwith SystemicLupus Erythematosus:A

Case Report

DOI: https://doi.org/10.46296/gt.v7i14edespdic.0200

CLINICAL PRESENTATION AND MANAGEMENT OF VASCULITIS IN AN

ADOLESCENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE

REPORT

PRESENTACIÓN CLÍNICA Y TRATAMIENTO DE LA VASCULITIS EN UN

ADOLESCENTE CON LUPUS ERITEMATOSO SISTÉMICO: INFORME DE

UN CASO

1

2

3

Palacios-Vargas Doris ; Moya-Guerrero Iván-Ricardo ; Salvador-Acosta Belén ;

4

Cobo-Álvarez Daniela Abigail

1

Hospital General Docente Ambato, Universidad Técnicade Ambato. Ambato, Ecuador.

Correo: dv.palacios@uta.edu.ec.

2

Hospital General Docente Ambato. Ambato, Ecuador. Correo: moguerr@hotmail.com.

3

Facultad de Medicina, Universidadde Las Américas. Quito, Ecuador.

Correo: maria.salvador.acosta@udla.edu.ec.

4

Hospital General Docente Ambato. Ambato, Ecuador.

Correo: dcoboalvarez@gmail.com. ORCID ID: https://orcid.org/0000-0002-3927-870X.

Abstract

Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disease with diverseclinical

manifestations, predominantly affecting females. This case report presents the clinical

presentation and management of vasculitis in a 16-year-old male with SLE, an atypical

demographic for the disease. The study examines the challenges of diagnosing and treating SLE

in adolescents. The patient exhibited polyserositis, cutaneous vasculitis, malar rash, and oral

ulcers. Diagnostic procedures included clinical evaluation, laboratory tests (ANA, anti-dsDNA,

complement levels), and a skin biopsy histopathological examination. Treatment consisted of

hydroxychloroquine, corticosteroids, and immunosuppressive agents. Laboratory findings

revealed positive ANA, elevated anti-dsDNA titers, and low complement levels, confirming SLE

with associated vasculitis. Histopathology verified skin-limited vasculitis. The patient responded

well to the treatment regimen, achieving remission and reducing disease flares. Regular

monitoring and a multidisciplinary approach were pivotal in managing the condition. This case

underscores the importance of considering SLE in atypical demographics, such as adolescent

males. Early diagnosis and comprehensive management are vital for improving outcomes and

quality of life. Further research is warranted to address the unique challenges and optimal

treatment strategies for pediatric and male SLE patients, emphasizing the need for awareness

and tailored therapeutic approaches in managing chronic autoimmune diseases in diverse

populations.

Keywords: Systemic Lupus Erythematosus (SLE); Vasculitis; Autoimmune Disease; Cutaneous

Manifestations.

Resumen

El lupus eritematoso sistémico(LES) es una enfermedad autoinmune multifacéticacon diversas

manifestaciones clínicas que afecta predominantemente a mujeres. Este informe de caso

presenta la presentaciónclínicay el tratamiento de la vasculitis en un varón de 16 años con LES,

un grupo demográfico atípico para la enfermedad. El estudio examina los desafíos del

diagnósticoy tratamiento del LES en adolescentes. El paciente presentó poliserositis, vasculitis

cutánea, erupción malar y úlceras orales. Los procedimientos de diagnóstico incluyeron

Información del manuscrito:

Fecha de recepción: 16 de septiembre de 2024.

Fecha de aceptación: 25 de noviembre de 2024.

Fecha de publicación: 27 de diciembre de 2024.

2

Palacios-Vargas et al. (2024)

evaluación clínica, pruebas de laboratorio (ANA, anti-dsDNA, niveles de complemento) y un

examen histopatológico de biopsia de piel. El tratamiento consistió en hidroxicloroquina,

corticosteroides y agentes inmunosupresores. Los hallazgos de laboratorio revelaron ANA

positivos, títulos elevados de anti-dsDNA y niveles bajos de complemento, lo que confirmó LES

con vasculitis asociada. La histopatología verificó vasculitis limitada a la piel. El paciente

respondió bien al régimen de tratamiento, logróla remisión y redujo los brotes de la enfermedad.

El seguimiento regular y un enfoque multidisciplinario fueron fundamentales para el manejo de

la enfermedad. Este caso destaca la importancia de considerar el LES en grupos demográficos

atípicos, como los varones adolescentes. El diagnóstico temprano y el tratamiento integral son

vitales para mejorar los resultados y la calidad de vida. Se justifican más investigaciones para

abordar los desafíos únicos y las estrategias de tratamiento óptimas para los pacientes

pediátricos y varones con LES, lo que enfatiza la necesidad de concienciación y enfoques

terapéuticos personalizados para el manejo de enfermedades autoinmunes crónicas en diversas

poblaciones.

Palabras claves: Lupus eritematoso sistémico (LES); Vasculitis; Enfermedad autoinmune;

Manifestaciones cutáneas.

(

ANA) positivity. Vasculitis, an

1. Introduction

inflammation of the blood vessels,

occurs in 11% to 20% of SLE

patients (3). Despite its significance

in the systemic expression of SLE,

Systemic Lupus Erythematosus

SLE) is a multifactorial autoimmune

(

disease characterized by a wide

array of clinical manifestations that

can involve one or more organs (1).

The incidence of SLE varies from 0.3

to 31.5 cases per 100,000 persons

the

vasculitis in SLE patients have not

been extensively studied (2).

clinical

characteristics

of

Additionally, ANCA-negative AAVs

represent a subgroup with clinical

and histological features of AAV but

without associated antibodies, often

showing limited or less severe

systemic renal involvement.

per year (2)., with global

prevalence ranging between 50 and

00 per 100,000 adults. Notably,

a

1

SLE predominantly affects females,

with nearly 10 female patients for

every male diagnosed with the

disease.

The diagnosis and management of

SLE in adolescents present unique

challenges due to the variability in

clinical presentation and the need for

In 2019, the European League

Against Rheumatism (EULAR) and

the

American

College

of

tailored

therapeutic

strategies.

Rheumatology (ACR) established

new classification criteria for SLE

that include antinuclear antibody

Adolescents, especially males, are

an atypical demographic for SLE,

which complicates the diagnostic

Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 7, Núm. 14 (Ed. Esp.

Diciembre 2024) ISSN: 2737-6273

Clinical Presentationand Managementof Vasculitis in an Adolescentwith SystemicLupus Erythematosus:A

Case Report

process and may delay appropriate

treatment. This case report presents

Abbreviations

SLE:

Systemic

Lupus

the

clinical

presentation

and

Erythematosus

management of a 16-year-old male

with SLE and associated vasculitis,

highlighting the importance of

ANA: Antinuclear Antibody

ACR:

American

College

of

considering atypical

demographics and the need for early

diagnosis and comprehensive

SLE

in

Rheumatology

EULAR: European League Against

Rheumatism

management to improve patient

outcomes and quality of life (4).

ANCA: Anti-Neutrophil Cytoplasmic

Antibodies

In this report, we present the case of

a 16-year-old male who presented

with polyserositis and cutaneous

AAV: ANCA-Associated Vasculitis

vasculitis.

literature, we also discuss SLE's

clinical and immunological

Based

on

current

TGO:

Transaminase

Glutamic-

Lupus

Oxaloacetic

characteristics in male patients,

highlighting the unique challenges in

diagnosing and managing SLE in this

demographic.

TGP:

Transaminase

Pyruvic

SLEDAI:

Systemic

Erythematosus Disease Activity

Index

2. Case Presentation

GC: Glucocorticoids

Patient Background: The patient is a

6-year-old male, born and resident

CY: Cyclophosphamide

1

of San Miguel de Guaranda,

Ecuador. He is a student with no

significant personal or family medical

history. The patient denies any toxic

habits, such as smoking or drug use.

Initial Symptoms: The patient

presented with symptoms that had

evolved over five months, becoming

more apparent in the last five days.

The primary symptoms included pain

and edema in the carpal joints,

4

Palacios-Vargas et al. (2024)

proximal

interphalangeal

joints,

Blood pressure: 117/78 mmHg

Heart rate: 100 beats per minute

knees, ankles, and hips. Morning

stiffness lasting less than 30 minutes,

causing functional limitations. Facial

edema, diffuse thinning, hair fragility,

non-painful oral lesions, generalized

weakness (asthenia).

Respiratory rate: 20 breaths per

minute

Oxygen saturation: 89% (FiO2 21%)

Body temperature: 36.5 degrees

Celsius (See Table 1)

Physical Examination: The initial

physical examination recorded the

following

vital

signs

and

observations:

Table 1. Summarizes the physical examination data:

Blood

Heart rate

Respiratory rate

Saturation

Temperature

pressure

117/78 mmHg

100 beats per

minute

20 breaths per

minute

89% FiO2

21%,

36.5 degrees

Celsius

identity. The clinical context suggests

a dermatologic manifestation of SLE

accompanied by possible signs of

vasculitis.

Clinical Observations

Skin: Pale, dry, desquamative skin;

diffuse alopecia; bilateral palpebral

edema; malar erythema in a butterfly

pattern, respecting the nasolabial

fold.

Figure 1. Facial Erythema and Rash in an

Adolescent with Systemic Lupus

Erythematosus and Vasculitis.

Figure 1 shows an adolescent with

systemic lupus erythematosus (SLE)

and vasculitis. The photo shows a

person with pale, dry, desquamative

skin. Head: diffuse alopecia. Bilateral

palpebral

edema

and

malar

erythema in butterfly wings that

respect the nasolabial fold are

characteristics of SLE. The eyes are

covered to protect the patient's

5

Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 7, Núm. 14 (Ed. Esp.

Diciembre 2024) ISSN: 2737-6273

Clinical Presentationand Managementof Vasculitis in an Adolescentwith SystemicLupus Erythematosus:A

Case Report

Figure 2. shows the open mouth of an

adolescent with oral ulcers on the soft

palate.

Figure 3. Lower Extremity Purpura in an

Adolescent with Systemic Lupus

Erythematosus and Vasculitis.

Figure 2. Oral Lesions in an

Adolescent with Systemic Lupus

Erythematosus and Vasculitis

Abdomen: no visceromegaly, fluid

sounds present, no appendicular or

peritoneal signs.

Figure 3 shows the legs of an

adolescent with systemic lupus

erythematosus (SLE) and vasculitis.

Chest: decreased expansibility at

bases. Heart: hypophonetic heart

The

lower

extremities

have

numerous scattered skin lesions,

seen as palpable purpura. These

lesions indicate the presence of

vasculitis, which is an inflammation

of the blood vessels. The lesions are

more concentrated in the lower areas

of the legs and ankles.

sounds.

Pulmonary:

Vesicular

murmur decreased at bases.

Table 2 presents the results of

complementary

tests

showing

anemia with low hemoglobin (8.8

g/dL) and reduced hematocrit

(

27.5%). Triglyceride levels are

elevated (347.1 mg/dL), and

significant liver dysfunction is

observed with highly elevated TGO

and TGP levels (795.7 U/L and 230.2

U/L,

respectively).

The

immunological analysis reveals the

presence of positive ANA (1:1280),

6

Palacios-Vargas et al. (2024)

elevated anti-double-stranded DNA

urinalysis shows the presence of

granular casts. TSH levels are

increased (13 uUI/mL), indicating

possible thyroid dysfunction.

(

>200

complement C3 (49.13 mg/dL). The

4-hour proteinuria is markedly high

4388.40 mg/24 hours), and the

IU/mL),

and

reduced

2

(

Table 2. Results of complementary tests.

Hemogram

Leukocytes

Hematocrit

Hemoglobin

MCV

6.05 10³/µL

27.5 %

8.8 g/dL

93.4 µm³

128 10³/µL

4 - 10

45 - 55

14.5 - 18.5

80 - 100

150 - 450

Platelets

Blood chemistry

Urea

Creatinine

Total bilirubin

TGO

TGP

Triglycerides

Direct COOMBS

Immunological

ANA

Anti-DNA C Double

Lupus Anticoagulant La

Complement C3

Complement C4

Anti-Cardiolipin Igm

ANCA C

51 mg/dl

10 - 50

0.8 - 1.3

0 - 1.2

0 - 38

0 - 42

0 - 150

0.84 mg/dl

0.36 mg/dl

795.7 U/L

230.2 U/L

347.1 mg/dL

Positive

1:1280 Positive

>200 IU/Ml

1: 30.50

Positive> 20

31-44

90-100

49.13mg/dl

16. 75 mg/dl

0.5 MPL-UmL

1.8 U/mL

9-36

Positive> 25

Positive>5

ANCA P

1.3 U/mL

Urinalysis

Proteinuria in 24 hours

TSH

granular casts 1-4

4388.40 mg/24 hours

13 uUI/mL

28 - 141

0.35 - 5.1

0.5 - 1.4

FT4

0.72 ng/dl

HBsAg and HCV negatives, Serology

for HIV and VDRL: Non-reactive.

Histopathology of skin biopsy of the

right leg confirmed vasculitis limited

to the skin. The diagnosis of systemic

lupus erythematosus was made

according to the diagnostic criteria

used by the American College of

Rheumatology. And a SLEDAI lupus

activity scale of 40 points, in addition

Abdominal

ultrasound:

splenomegaly, right pleural effusion.

Chest X-ray: scant bilateral pleural

effusion. Echocardiogram: preserved

left ventricular systolic function LVEF

to

cutaneous

vasculitis

and

65%.

hypothyroidism.

7

Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 7, Núm. 14 (Ed. Esp.

Diciembre 2024) ISSN: 2737-6273

Clinical Presentationand Managementof Vasculitis in an Adolescentwith SystemicLupus Erythematosus:A

Case Report

Figure 4. An adolescent with an

improvement of malar erythema and

alopecia.

As an induction of treatment, he

received pulses of corticosteroids

with 1g of methylprednisolone

succinate in 3

consecutive days, followed by oral

prednisone. As maintenance

2

hours for

therapy, he received mycophenolate

mofetil 500mg every 8 hours and

hydroxychloroquine 200mg per day,

prednisone 30mg with weaning.

progressive, losartan 50mg as

antiproteinuric. After a month he

went to follow-up, asymptomatic,

with

a

Hemogram: Leukocytes

Hemoglobin: 12.4

10040,

3

. Discussion

Hematocrit: 39, Platelets: 331000,

Glucose: 89 Creatinine: 0.72 mg/dl,

TGO: 17 U/L, TGP: 17 U/L,

Proteinuria in 24 hours 2084 U/L with

SLDAI 8points.

This case highlights the unusual

presentation of SLE in a male

adolescent, which is atypical given

that the disease predominantly

affects females in a 9:1 ratio. This

Figure 4 shows an adolescent with

systemic lupus erythematosus (SLE)

and vasculitis. In the photo, a person

with improvement of malar erythema

and alopecia.

uniqueness

underscores

the

importance of considering SLE in

differential diagnoses for young male

patients with compatible symptoms

(

5), (6).

The clinical

presentation and

management of SLE with vasculitis in

adolescents

diagnostic

pose

and

significant

therapeutic

challenges. Variability in clinical

manifestations can delay proper

8

Palacios-Vargas et al. (2024)

diagnosis and, thus, initiation of

optimal treatment, which is crucial to

prevent complications and improve

long-term outcomes (2), (7).

95%), followed by skin involvement

in 60-85% of cases, the latter being

the first sign of the disease in 23-28%

of cases (10).

The

reason

lupus

occurs

Among the specific symptoms are

fever, a wide variety of cardiac and

pulmonary pathology; nephropathy,

a common complication of SLE that

affects 50% of patients; digestive

manifestations skin manifestations;

and arthritis, 50% of patients with

SLE present anemia (11).

predominantly in women is difficult to

explain. Sex-related genes and

hormones may be essential in

etiopathogenesis (7).

The diagnosis is usually made in

young women between 20 and 40

years of age; however, it can begin at

any age and will be classified as a

juvenile (jSLE) when it begins before

the age of 16 years (8), (9).

Newer classification criteria allow

earlier classification of SLE, and the

combination of the three (ACR-1997,

SLICC-2012, and EULAR/ACR-

Vasculitis is an inflammation of the

vessel walls. Although it is a

characteristic process involved in the

systemic expression of SLE, few

studies have specifically analyzed

2

019) warrants diagnosis of patients.

positive ANA or other

immunological (autoantibody or

A

hypocomplementemia) is required to

classify SLE according to SLICC-

the

clinical

characteristics

of

2012 and EULAR/ACR-2019 criteria

vasculitis in patients with SLE. Most

studies that analyze the prevalence

of vasculitis in large series of patients

with SLE show a prevalence that

ranges between 11% and 20%, 68

(

12), (13).

ANCA-negative

subgroup with

AAVs

are

a

clinical

and

histological characteristics of AAV

but with adverse antibody reports.

The literature describes these

patients' apparent limited or less

severe systemic renal involvement

(

89%) women and 8 (11%) men (6).

Within the broad spectrum of clinical

manifestations

musculoskeletal

of

SLE,

is

involvement

(

4).

reported as the most frequent (80-

9

Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 7, Núm. 14 (Ed. Esp.

Diciembre 2024) ISSN: 2737-6273

Clinical Presentationand Managementof Vasculitis in an Adolescentwith SystemicLupus Erythematosus:A

Case Report

The treatment of SLE must be

individualized and will depend on the

type of manifestation, the organ(s) or

systems involved, and the severity of

the disease. Severe manifestations

include involvement of a major organ

and endanger life or function, risk of

chronic damage with significant

organic sequelae (e.g., lupus

agents (methotrexate, azathioprine,

mycophenolate) may accelerate the

gradual reduction or discontinuation

of glucocorticoids. In persistently

active or exacerbated disease, the

addition of belimumab should be

considered;

Rituximab

or

cyclophosphamide (CY) may be

considered in refractory organ-

threatening disease (2).

glomerulonephritis,

neurological condition, pulmonary

hemorrhage, vasculitis, lupus

severe

In the past two years, several new

therapies

targeting

different

bullous. These manifestations may

be treated with high-dose GC or

boluses of cyclophosphamide or,

molecular pathways have shown

encouraging results in clinical trials in

SLE.

After the approval of

mycophenolic

acid

or

other

belimumab,

humanized

trials

with

fully

immunosuppressants (14).

B-cell-targeted

Treatment goals include long-term

patient survival, organ damage

prevention, and quality of life

monoclonals or combinations of

biologics were initiated. A second

group of drugs targets interferon,

either directly, such as nivolumab

and sarilumab, or more indirectly,

such as BIIB059 or omalizumab (5).

improvement.

Therapy

should

achieve remission or at least low

disease activity and prevention of

flares. All patients with lupus should

receive hydroxychloroquine at a

dose not to exceed 5 mg/kg body

weight. During chronic maintenance

therapy, glucocorticoids should be

minimized to less than 7.5 mg/day

Figure 5 shows the treatment options

for adolescents with systemic lupus

erythematosus (SLE) and vasculitis,

dividing them into initial and

maintenance

treatments

and

specifying the medications used in

each category.

(

prednisone equivalent) and, when

possible, withdrawn. Appropriate

initiation of immunomodulatory

10

Palacios-Vargas et al. (2024)

Figure 5. SLE treatment regimen with vasculitis

presence of positive antinuclear

antibodies (ANA), high titers of anti-

double-stranded DNA (dsDNA)

4

. Conclusions

This case report highlights the

complexity of diagnosing and

antibodies, and low complement

levels (C3 and C4) were crucial to

confirm the diagnosis of SLE. Skin

biopsy confirmed the presence of

managing

systemic

lupus

erythematosus (SLE) with vasculitis

in a male adolescent, an unusual

demographic for this predominantly

female disease. The patient's

vasculitis,

highlighting the

of histopathologic

importance

presentation

with

polyserositis,

examination in diagnosing systemic

involvement.

cutaneous vasculitis, and typical

features of SLE, such as malar rash

and oral ulcers, underscores the

diverse clinical manifestations of

SLE.

Management of SLE in this patient

focused on controlling disease

activity and preventing organ

damage.

Hydroxychloroquine,

and

The diagnostic process was based

on clinical evaluation, laboratory

findings, and imaging studies. The

corticosteroids,

immunosuppressive agents were

adjusted to achieve remission and

11

Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 7, Núm. 14 (Ed. Esp.

Diciembre 2024) ISSN: 2737-6273

Clinical Presentationand Managementof Vasculitis in an Adolescentwith SystemicLupus Erythematosus:A

Case Report

reduce the risk of flares. This case

also illustrates the importance of

research committee, along with the

1964 Helsinki Declaration and its

later amendments or comparable

ethical standards.

regular

monitoring

and

multidisciplinary care in managing

chronic autoimmune diseases such

as SLE.

Informed consent to participate in

this study was obtained from the

patient and her legal guardian. The

patient and her legal guardian

received complete information about

the study's objectives, procedures,

potential risks, and benefits. They

were assured that participation was

voluntary and that they could

withdraw from the study without

consequences for their medical care.

Finally, this case underscores the

need for greater awareness of SLE

and its potential complications in

adolescents, including males, who

may

present

with

atypical

manifestations. Early diagnosis and

comprehensive management are

essential to improve these patients'

outcomes and quality of life. More

research is needed to explore the

unique challenges and optimal

treatment strategies for pediatric and

male patients with SLE.

Author

Conceptualization, Doris Palacios-

Vargas, Iván-Ricardo Moya-

Guerrero, Belén Salvador-Acosta,

and Patricia Acosta-Vargas;

Methodology, Doris Palacios-

Contributions:

Declarations

Ethics approval and consent to

participate

Vargas, and Patricia Acosta-Vargas;

Validation, Doris Palacios-Vargas,

and Patricia Acosta-Vargas; Formal

Analysis, Doris Palacios-Vargas,

Iván-Ricardo Moya-Guerrero, Belén

The study protocol was reviewed and

approved by the Institutional Review

Board of the Ambato Regional

Salvador-Acosta,

Acosta-Vargas; Investigation, Doris

Palacios-Vargas, Iván-Ricardo

and

Patricia

Hospital

(Approval

Number:

HR2023-00124). All procedures

performed in this study involving the

patient followed the ethical standards

of the institutional and national

Moya-Guerrero, Belén Salvador-

Acosta, and Patricia Acosta-Vargas;

Resources, Patricia Acosta-Vargas;

12

Palacios-Vargas et al. (2024)

Writing—Original Draft Preparation,

Doris Palacios-Vargas, Iván-Ricardo

Moya-Guerrero, Belén Salvador-

Acosta, and Patricia Acosta-Vargas;

Writing—Review and Editing, Doris

used in this study are not publicly

available. Data sets used during this

study are available from the

corresponding

author

upon

reasonable request.

Palacios-Vargas,

Iván-Ricardo

Conflicts of Interest: The authors

declare no conflicting financial

interests or personal relationships

that could appear to influence the

work described in this article.

Moya-Guerrero, Belén Salvador-

Acosta, and Patricia Acosta-Vargas;

Supervision, Patricia Acosta-Vargas;

Project

Administration,

Patricia

Acosta-Vargas; Funding Acquisition,

Patricia Acosta-Vargas. All authors

have read and agreed to the

published version of the manuscript.

Acknowledgments

The authors sincerely thank the

patient and their family for their

willingness to participate in this study

and for providing the necessary

information. We also thank the

medical and nursing staff at Hospital

General Docente Ambato for their

support and dedication to patient

care. Thanks to the Universidad

Técnica de Ambato and Universidad

de Las Américas for their institutional

support. We also thank the Intelligent

and Interactive Systems Laboratory

at Universidad de Las Américas for

Funding: Universidad de Las

Américas-Ecuador

funded

this

research as part of the internal

research project 489. A.XIV.24.

Institutional

Statement:

Review

This study

Board

was

conducted following the guidelines of

the Declaration of Helsinki and was

approved by the Institutional Review

Board of the Hospital Regional

Ambato.

Statement of Informed Consent:

The patient provided written informed

consent to publish this case report

and the accompanying images.

providing

the

resources

and

infrastructure necessary to conduct

this research. Finally, we would like

to acknowledge

the valuable

feedback and guidance from our

Data Availability Statement: For

colleagues

and

mentors

in

patient privacy reasons, the data

rheumatology

autoimmune

13

Revista Científica Arbitrada en Investigaciones de la Salud ‘‘GESTAR”. Vol. 7, Núm. 14 (Ed. Esp.

Diciembre 2024) ISSN: 2737-6273

Clinical Presentationand Managementof Vasculitis in an Adolescentwith SystemicLupus Erythematosus:A

Case Report

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