• Ayşe Gültekingil Keser, İlker Ertuğrul, Özlem Tekşam, Bahadir Konuşkan, Süheyla Özkutlu, and Seza Özen.
• From the Department of Pediatrics, Division of Pediatric Emergency, Hacettepe University Faculty of Medicine, İhsan Dogramaci Children's Hospital, Sihhiye/Ankara, Turkey.
• Pediatr Emerg Care. 2017 Oct 1; 33 (10): e100-e102.

IntroductionSystemic lupus erythematosus (SLE) is a multisystemic autoinflammatory disease that can involve any organ system; therefore, diagnosis can be challenging. Hereby, we present 4 cases that presented to pediatric emergency department with unusual clinical pictures of SLE.CasesCase 1 presented with inability to walk or talk for the last 1 week as well as intermittent pain and swelling in her joints. Case 2 presented with generalized edema and severe dyspnea. Case 3 and 4 presented to pediatric emergency department with rashes on the legs.DiscussionSystemic lupus erythematosus may mimic many clinical entities, and differential diagnosis may be difficult, especially if presentation is atypical. In every emergency physician, right diagnosis and prompt treatment are very important especially in life-threatening conditions such as cardiac involvement in SLE.

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