title: Neuropsychiatric Symptoms as The First Manifestation of Juvenile Systemic Lupus Erythematosus: A Complicated Case with Klinefelter's Syndrome.
abstract: Systemic Lupus Erythematosus (SLE) is an autoimmune, multisystem disorder with various manifestations. There are limited reports on the neuropsychiatric findings as the first manifestation of SLE in children. Herein, we report a 14-year-old Iranian boy with a two-year history of cognitive dysfunction and behavioural problems as well as a recent history of epistaxis. The patient workup ended with a diagnosis of Klinefelter's syndrome associated with juvenile SLE. Patients with Klinefelter's syndrome may exhibit behavioural problems and psychological disease. These psychiatric disorders could be complicated with lupus in children. In fact, psychiatric symptoms may occur as the first manifestation of juvenile SLE. Specially, if accompanied with Klinefelter's syndrome. We suggest the diagnosis of SLE must be considered in all children with neuropsychiatric manifestations.
authors.affiliation: Department of Paediatric Rheumatology, Shahid Behshti University of Medical Sciences, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Shiari
authors.affiliation: Department of Paediatric Rheumatology, Shahid Behshti University of Medical Sciences, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Mehrnoush
authors.initials: M
authors.lastname: Hassase Yegane
authors.affiliation: Department of Genetics, Faculty of Biological Science, Shahid Beheshti University, GC, Tehran, Iran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Farivar
authors.affiliation: Department of Paediatric Rheumatology, Shahid Behshti University of Medical Sciences, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Vadood
authors.initials: V
authors.lastname: Javadi Parvaneh
authors.affiliation: Department of Paediatric Rheumatology, Shahid Behshti University of Medical Sciences, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Seyed Alireza
authors.initials: SA
authors.lastname: Mirjavadi
keywords: Cognitive Dysfunction; Juvenile Systemic Lupus Erythematosus; Klinefelter’s syndrome; Neuropsychiatric