Table 1 Chronology of clinical features, laboratory results, and treatment modalities
From: Presentation of SLE after COVID vaccination in a pediatric patient
|  | Day 0 (administration of 3rd SARS-CoV-2 Pfizer-BioNTech mRNA vaccine | Day + 4, saw pediatrician and was referred to dermatologist | Day + 20, seen by pediatric dermatology | Day + 35–38, seen by pediatric rheumatology and nephrology |
|---|---|---|---|---|
Clinical features | Â | Rash (face, with spread to knees and arms) | Persistent rash, joint pains, hair loss, and light sensitivity | Arthritis bilateral elbows, also found to have palatal erythema and persistent rash |
Laboratory results |  | +ANA (1:80), +dsDNA, +Smith, +RNP, +Ro antibodies, low complements (C3 43, C4 7) |  | ANA 1:1280 with confirmed Smith/RNP, dsDNA, Ro+ antibodies; urine protein: creatinine elevated to 13.5 mg/mg |
Treatment |  | Topical steroid cream | Oral cephalexin | Mycophenolate mofetil 1000 mg twice daily; hydroxychloroquine 300 mg daily; Prednisone 60 mg’ daily; famotidine 20 mg daily |