Compassion-based positive psychology group intervention (CB-PPGI) for individuals with personality disorders awaiting intensive treatment: a mixed-methods study of preliminary outcomes and acceptabili

Systemic lupus erythematosus (SLE) is a heterogeneously presenting, chronic, multisystem autoimmune disease. Neurological manifestations of SLE can affect both central and peripheral nervous systems and are associated with reduced health‐related quality of life and increased mortality., , While most neurological manifestations occur around the time of SLE diagnosis, they may precede diagnosis, creating diagnostic and therapeutic challenges. Mononeuritis multiplex (MNM) is a rare SLE manifestation, usually occuring years after diagnosis. We present an 11‐year‐old girl who presented with severe, rapidly progressive MNM due to SLE. This is the first report of MNM as the initial SLE manifestation in a pediatric patient, and only the second report of MNM at time of SLE diagnosis. This previously healthy 11‐year‐old girl presented with progressively worsening distal right leg pain, antalgic gait, and intermittent fever, preceded by recent influenza A infection. Her evaluation was significant for normocytic anemia, elevated inflammatory markers, and magnetic resonance imaging (MRI) suggestive of an inflammatory myopathy (Figure ). The differential diagnosis included postinfectious reactive myositis versus new‐onset chronic immune‐mediated inflammatory disease. She was discharged on a prednisone taper with further evaluation pending. (A) Right distal leg magnetic resonance imaging (MRI) reveals abnormal increased T2 signal and enhancement involving nearly all visualized musculature, suggestive of inflammatory myopathy. (B) Bilateral leg MRI with STIR (short tau inversion recovery) sequences shows progression of the diffuse hyperintensity in thigh muscles, likely representing myositis or neurogenic atrophy.