cutaneous vasculitis, lymphopenia, positive antinuclear
and anti-dsDNA antibodies) receiving chloroquine
and deflazacort presented to an emergency
room with acute right lower abdominal pain.
She had nausea and vomiting but no fever, dysuria,
urinary frequency, alteration in intestinal habits,
vaginal bleeding or discharge. She had not experienced
menarche, denied sexual activity, and had a
pubertal Tanner stage of B3/G3. Physical examination
revealed marked tenderness in the right lower
quadrant. Laboratorial findings included a low
hemoglobin level (9.8 g/dL) without evidence of
hemolysis, normal platelet count, high white blood
cell count (12,400/mm3
) and high neutrophil count
(10,540/mm3
), low lymphocyte count (726/mm3
),
high serum creatinine concentration (1.5 mg/dL),