Morning Stiffness >1 Hour in Pediatrics — 11yo Child | Pediatric Rheumatology | SMLE Q#11852
SMLE Question #11852
Pediatrics
Pediatric Rheumatology
Objective: OBJ-1767
Last updated: February 2026
An 11-year-old boy has 3 months of symmetric wrist and knee arthritis with morning stiffness >1 hour, low-grade fevers, and fatigue. Examination shows a malar rash sparing the nasolabial folds and small effusions with reduced range of motion in both wrists and knees. There is no peripheral edema, and neurologic examination is normal. Investigations support a diagnosis of systemic lupus erythematosus with no evidence of renal involvement on screening. Which is the most appropriate disease-modifying medication to start now for long-term SLE management?
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