Diffuse lymphadenopathy as the presenting manifestation of systemic lupus erythematosus

Lanaya Williams Smith, Michelle Petri

Research output: Contribution to journalArticle

Abstract

We report the case of a 27-year-old African American man who presented with 6 months of generalized lymphadenopathy and nothing in his history or examination to suggest systemic lupus erythematosus (SLE). He was thought to have lymphoma, syphilis, or tuberculosis, and an extensive workup was done. Laboratory investigation finally revealed leukopenia (4.0), proteinuria (1.87 g), antinuclear antibodies (640 speckled), anti-double-stranded DNA (640), anticardiolipin immunoglobulins G and M, anti-Smith, Coombs, anti-Ro, anti-La, CK (531 U/L), aldolase (8.5 U/L), high erythrocyte sedimentation rate (130 mm/h), and low complement (C3 15 mg/dL and C4 3 mg/dL). A kidney biopsy showed diffuse proliferative glomerulonephritis, International Society of Nephrology class IV. Generalized lymphadenopathy as the first and only manifestation for 6 months made the diagnosis of SLE challenging. Generalized diffuse lymphadenopathy has been associated with SLE but is much lessfrequent now than in the past. The differential diagnosis of lymphadenopathy relevant to rheumatologists includes Kikuchi histiocytic necrotizinglymphadenitis, Castleman disease, syphilis, tuberculosis, sarcoidosis, and lymphoma.

Original languageEnglish (US)
Pages (from-to)397-399
Number of pages3
JournalJournal of Clinical Rheumatology
Volume19
Issue number7
DOIs
StatePublished - Oct 2013

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Systemic Lupus Erythematosus
Syphilis
Lymphoma
Tuberculosis
Giant Lymph Node Hyperplasia
Fructose-Bisphosphate Aldolase
Complement C3
Antinuclear Antibodies
Blood Sedimentation
Leukopenia
Sarcoidosis
Glomerulonephritis
Proteinuria
African Americans
Immunoglobulin M
Differential Diagnosis
Immunoglobulin G
History
Kidney
Biopsy

Keywords

  • lymphadenopathy
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

Cite this

Diffuse lymphadenopathy as the presenting manifestation of systemic lupus erythematosus. / Smith, Lanaya Williams; Petri, Michelle.

In: Journal of Clinical Rheumatology, Vol. 19, No. 7, 10.2013, p. 397-399.

Research output: Contribution to journalArticle

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