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Despite the initiation of glucocorticoids, she went on to develop renal and neuropsychiatric involvement which only responded to high-dose immunosuppression including plasma exchange. This case demonstrates the aggressiveness and rapidity of organ involvement in juvenile-onset SLE and the need for timely appropriate immunosuppression and treatment escalation.<\/jats:p>","DOI":"10.1136\/bcr-2024-260733","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T07:11:44Z","timestamp":1741331504000},"page":"e260733","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Juvenile-onset systemic lupus erythematosus with multisystem involvement complicated by posterior reversible encephalopathy syndrome (PRES)"],"prefix":"10.1136","volume":"18","author":[{"given":"Erika","family":"Cefai","sequence":"first","affiliation":[{"name":"Rheumatology, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Grima","sequence":"additional","affiliation":[{"name":"Paediatrics, Mater Dei Hospital, Msida, 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