Diagnosis of juvenile systemic lupus erythematosus in adolescents with Hashimoto's thyroiditis: two case reports.

OBJECTIVES

To report the unusual diagnosis of juvenile systemic lupus erythematosus (JSLE) in two adolescents with a previous diagnosis of Hashimoto's thyroiditis (HT).

CASE REPORTS: Case # 1: An 11 year-old girl was diagnosed with HT. One year later, she presented with generalized edema, pericardial and pleural effusion, positive ANA, thrombocytopenia, increased anti-cardiolipin IgG and nephritis, being diagnosed with JSLE. (Case # 2): A 13 year-old girl was diagnosed with HT at the age of 10 years. Two years later, she presented with weight loss, knee and elbow arthritis, alopecia, leukopenia, and positive ANA and dsDNA autoantibody confirming the diagnosis of JSLE. The first patient was treated with prednisone and cyclophosphamide, and the second with prednisone and hydroxychloroquine with both achieving relief of the lupic symptoms.

CONCLUSION

In spite of the known association between autoimmune diseases and thyroid disorders, the occurrence of JSLE in patients with a previous diagnosis of HT is rare. It is important to bear in mind this possibility when following patients with HT in order to not delay the diagnosis and treatment of a serious systemic autoimmune disease such as JSLE.