“…This study accordance with Lewandowski, et al (2017) (30) , who studied " missed opportunities for timely diagnosis of pediatric lupus in South Africa: a qualitative study" and found that, the majority of SLE patients in this study 63% had severe symptoms such as arthritis , skin rash fatigue, GIT disturbance and pericarditis requiring intervention at the time of diagnosis. That's go in the same direction with Mohamady, et al (2022) (29) , the most common symptoms of studied females were fatigue 87.9%, pain 74.2%, skin rash 71.2% as well, 69.7% had hair loss & 60.6% complaining of arthritis As regards, previous hospitalization, less than one third of studied children had one pervious hospitalization. This result was supported Shoeib, et al (2018) (31) , who studied "Hospitalization of systemic lupus patients " and mentioned that more than two fifth of studied patient admitted to hospital one time, while more than three quarters of studied patient the cause of admission was nephritis.…”