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Childhood-onset systemic lupus erythematosus (cSLE) is a multisystem disease; its severity depends on the organs involved. Monogenic diseases have been described as predisposing to the onset of cSLE. Analytical and immunological tests are used for diagnostic confirmation. The main goal of treatment is remission and flare prevention. Here we describe the clinical case of a patient with prolonged febrile syndrome, arthralgias, and anemia, positive analytical tests for antinuclear antibodies and anti-DNA antibodies and low values of complement C3, C4, and C1q; so the patient was diagnosed with cSLE associated with C1q deficiency. Patients with C1q deficiency present with early onset of disease and significant target organ damage with nephritis. An early diagnosis of cSLE is important to ensure an early and appropriate treatment. Treatment may be personalized depending on the underlying defect that generates the subtype of lupus., (Sociedad Argentina de Pediatría.)

Pylephlebitis is defined as suppurative thrombosis of the portal vein as a complication of abdominal infections. In pediatrics, the most frequent etiology is appendicitis, generally of late diagnosis, presenting as sepsis, with a high mortality rate. Imaging methods are necessary for diagnosis; the most common are the Doppler ultrasound and computed tomography angiography. Treatment is based on surgery, antibiotic therapy, and anticoagulation. The indication for the latter is controversial, but it may improve prognosis and decrease morbidity and mortality. Here we describe a clinical case of pylephlebitis secondary to Escherichia coli sepsis, which started as acute appendicitis in a pediatric patient who progressed to cavernomatous transformation of the portal vein. It is important to know the management of this disease because, once the initial symptoms are overcome, it will require close follow-up due to a potential progression to liver failure., (Sociedad Argentina de Pediatría.)

Osteomyelitis is defined as an inflammation of the bone caused by infection. Acute osteomyelitis is common in pediatrics. A Brodie abscess is a type of subacute osteomyelitis, with a historically low incidence; however, its incidence is currently increasing. Given its little clinical impact, with non-specific laboratory tests and radiological studies of difficult interpretation, diagnostic suspicion is crucial. It resembles neoplasms, either benign or malignant. An adequate diagnosis falls on the health care provider's experience. Treatment consists of antibiotics, both parenteral and oral, with potential surgical drainage. Here we describe the case of a healthy female patient with a tumor found in the topography of the left clavicle 3 months before. She was diagnosed with Brodie abscess; treatment was started with a good response. A high index of suspicion of Brodie abscess is critical to avoid invasive tests and studies or inadequate treatments, and to prevent future sequelae., (Sociedad Argentina de Pediatría.)