Rowell’s syndrome: A rare presentation of childhood lupus

Abstract

A 11-year-old girl presented to the clinic with intermittent fever, multiple erythematous maculopapular lesions (erythema multiforme (EM) like lesions) of targetoid appearance over face, trunk, and limbs (Fig. 1), and a large palatal ulcer (Fig. 2). She was tested positive for ANA by Hep-2 (speckled pattern) and for anti-Ro, anti-nucleosome, anti-histone, and anti-dsDNA antibodies by immunoblot. She had reduced complement levels (C3, C4) and tested negative for rheumatoid factor and viral markers. Further evaluation has concluded that the patient met the diagnostic criteria for Rowell’s syndrome.