Mixed movements disorders as an initial feature of pediatric lupus.
Systemic lupus erythematosus (SLE) is an immunologic disease of the early adulthood. In children, SLE is rare and neurological onset is uncommon. We report on an observation of pediatric lupus in heterozygous twins revealed by mixed movement disorders.


METHODS
An 8-year-old boy, born to non consanguineous parents, with a family history of depression and a personal history of macular eruption, inflammatory polyarthralgias and a recurrent angina presented with acute movement and mood disorders. Neurological exam showed mild generalized choreic movements with motor and vocal tics. Antinuclear antibodies were positive. Brain MRI was normal. One year after, his twin brother presented with the same features.


CONCLUSIONS
Movement disorders are described in pediatric lupus but are unusual as inaugural features of the disease. In SLE, movement disorders such as chorea are usually reported. However, Tics seem to be exceptional. Pathophysiology remains unclear. Early onset and familial form support genetic implication in the pathogenesis of lupus.


CONCLUSIONS
Immune-mediated movement disorders such as in SLE are an established cause of acute movement disorders in child.
Department of Child and Adolescent Neurology, National Institute Mongi Ben Hamida of Neurology, Tunis, Tunisia.
Saloua
S
Mrabet
Department of Child and Adolescent Neurology, National Institute Mongi Ben Hamida of Neurology, Tunis, Tunisia. Electronic address: hanenebenrhouma@yahoo.fr.
Hanene
H
Benrhouma
Department of Child and Adolescent Neurology, National Institute Mongi Ben Hamida of Neurology, Tunis, Tunisia.
Ichraf
I
Kraoua
Department of Child and Adolescent Neurology, National Institute Mongi Ben Hamida of Neurology, Tunis, Tunisia.
Amira
A
Naas
Department of Child and Adolescent Neurology, National Institute Mongi Ben Hamida of Neurology, Tunis, Tunisia.
Nedia Ben
NB
Achour
Department of Child and Adolescent Neurology, National Institute Mongi Ben Hamida of Neurology, Tunis, Tunisia.
Hedia
H
Klaa
Department of Child and Adolescent Neurology, National Institute Mongi Ben Hamida of Neurology, Tunis, Tunisia.
Ilhem
I
Turki
D000974:Antibodies, Antinuclear / Q000276:immunology; D002648:Child; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D009069:Movement Disorders / Q000150:complications / Q000175:diagnosis*; D009483:Neuropsychological Tests; D010375:Pedigree; D035781:Siblings; D014427:Twins
D000974:Antibodies, Antinuclear
Childhood; Chorea; Lupus; Tics