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 language | English (US) |
|---|---|
| Pages (from-to) | 397-399 |
| Number of pages | 3 |
| Journal | Journal of Clinical Rheumatology |
| Volume | 19 |
| Issue number | 7 |
| DOIs | |
| State | Published - Oct 2013 |
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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 journal › Article
}
TY - JOUR
T1 - Diffuse lymphadenopathy as the presenting manifestation of systemic lupus erythematosus
AU - Smith, Lanaya Williams
AU - Petri, Michelle
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
KW - lymphadenopathy
KW - systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=84885180511&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885180511&partnerID=8YFLogxK
U2 - 10.1097/RHU.0b013e3182a6a924
DO - 10.1097/RHU.0b013e3182a6a924
M3 - Article
C2 - 24048114
AN - SCOPUS:84885180511
VL - 19
SP - 397
EP - 399
JO - Journal of Clinical Rheumatology
JF - Journal of Clinical Rheumatology
SN - 1076-1608
IS - 7
ER -