Contemporaneous Onset of Systemic Lupus Erythematosus and Severe Eating Disorder: Neither the Chicken Nor the Egg

This case report discusses a 14-year-old girl who simultaneously developed systemic lupus erythematosus (SLE) and an eating disorder (ED), specifically avoidant and restrictive food intake disorder (ARFID). The study suggests that rather than a direct causal link between SLE and ED, a third mediating factor, such as the emotional, social, and physical changes of adolescence, may influence both conditions. The patient presented with severe malnutrition, hair loss, and other symptoms, leading to a diagnosis of SLE and ARFID. Treatment included enteral feeding, prednisone, hydroxychloroquine, and psychological support, resulting in improved health outcomes. The report emphasizes the importance of recognizing the potential shared risk factors in managing these conditions, as treatment for neuropsychiatric lupus can carry significant risks.