Systemic Lupus Erythematosus (SLE) cases in pediatric are uncommon, compared to adult patients, who are mostly undetected at primary healthcare, especially with subtle clinical manifestations. Detection is necessary as early as possible so that further progressivity can be controlled. A 12-year-old child came with a rash on the face confirmed by a physical examination as malar rash and discoid rash. Laboratory results showed a positive antinuclear antibody (ANA) and double-stranded DNA (dsDNA) while complete blood count, liver function test, kidney function test and urinalysis were found within normal limits. Based on those findings we conclude that the diagnosis was SLE with subtle clinical manifestation. Evaluation needs to be done at least every 6 months as a scoring of the activity of disease and organ damage. The evaluation includes signs and symptoms, laboratory work-up such as complete blood count, organ function test, urinalysis, and immunologic parameters.

Keywords: systemic lupus erythematosus, pediatric, subtle clinical manifestation