Multiple sclerosis and systemic lupus erythematosus in a 10-year-old girl.

Systemic lupus erythematou s (SLE) is uncommon in children and multiple sclerosis (MS) is extre mely rare. Both the di seases have a chronic, relaps ing course and very rarely they have occurred in the same indi-vidual^) wh en a com mon und erlying etiology has been suggested(2). Both SLE and MS are asso ciated with HLA-DR2 allele and have occurred in twins of successive generatio ns(3). We describe co-occurrence of MS and SLE in a 10 year old girl who had the first neurolo gical ep isode at the age of 5 years. To the best o f our knowledge , this is the first description of MS and SLE occur ring together in a child. A 10-year-old girl wa s fir st hosp ital-ized at the age of 5 years when s he had presented with urinary retention. She completely recovered over a period of 10 days bu t on e mon th later pr esen ted with qu adr iparesis with uppe r mo tor neu ron signs. She was admitted with the dia gnosis of myelopathy with cervica l loca lization. This time also she recovered comple tely over a period of one month without any spe cific therap y and remained well till April 1992 when she came to us with acute renal failure requiring peritoneal dialysis. Investigat ions snowed a strongly positive Fluorescent Antinuclear Antibody (FANA) test. There was no history of malar or other rashes, photosensitivity, joint involvement or oral ulcers. Renal functions normali zed and urinar y abnorma lities disappe ared on oral prednisolone therapy over a period of 2 months. She was again hospita lized in September 1992 with a comp laint of sudden loss of vision in both the eyes. Examination revealed bilateral optic neuritis. No other neurological abnormality was present. In view of three separate episodes of neurodeficits involving different sites of the centra l nervous system, she was diagnosed to have clinically definite relapsing remitt ing mul tiple sclerosis(4). Two days after admiss ion, she had one episode of generali zed tonic-clonic conv ulsion, which did not recur after she was put on dilantin. There was gradual improvement in vision on stero id ther apy. Sh e was ab le to read fine prints by 18 days of therapy and was discharg ed from the hospital. She was attending school and leading a normal life till March 1993 …