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The clinical picture of neuropsychiatric SLE (NPSLE) is highly variable, and neurological features can precede systemic findings, leading to some diagnostic difficulties. NPSLE requires early and aggressive immunosuppressive therapy. Some patients can be resistant to immunosuppressive therapy. Chorea is a rare manifestation that occurs in 1.2%\u20132% of SLE patients and can result from an immunologically mediated mechanism, antiphospholipid autoantibodies or ischemia. Herein we present the first case of pediatric-onset SLE diagnosed with central nervous system involvement and treated with Zipper method. The Zipper method is a new immunomodulation treatment. The clinical findings of the patient, which were resistant to corticosteroids and cyclophosphamide, resolved by this novel treatment.<\/jats:p>","DOI":"10.1177\/0961203320984013","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T19:28:54Z","timestamp":1610566134000},"page":"502-509","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["A novel therapeutic approach using the Zipper method to treat chorea in a pediatric-onset systemic lupus erythematosus patient"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5637-8553","authenticated-orcid":false,"given":"Esra","family":"Baglan","sequence":"first","affiliation":[{"name":"Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semanur","family":"Ozdel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mutlu","family":"Uysal Yaz\u0131c\u0131","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebru","family":"Azapa\u011fas\u0131","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halil","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Y\u00fcksel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berna","family":"U\u00e7an","sequence":"additional","affiliation":[{"name":"Pediatric Radiology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Karakaya","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Bulbul","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Klein-Gitelman M Lane JC. 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