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A 16-year-old girl presented with two episodes of headache, neck pain and vomiting in the last 4 months. In the first episode, she was treated with antibiotics for 5 days following which steroids were added, as her symptoms did not resolve. She had aggravation of symptoms when steroids were tapered with additional right lateral rectus palsy and left knee joint swelling. She had intermittent exertional dyspnoea, photosensitive rashes on cheeks, weight loss, pallor and clubbing. She had 4/5 power at bilateral hip joints. …
AD and AKS are joint senior authors.
Contributors PR managed the patient AD planned and wrote the initial draft AS modified and critical appraised the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.