Department of Internal Medicine, Division of Rheumatology and Immunology, Akdeniz University School of Medicine, Antalya, Turkey.
Lupus. 2010 Mar;19(3):323-6. doi: 10.1177/0961203309346904. Epub 2009 Dec 10.
Systemic lupus erythematosus (SLE) is a disease with wide range of signs and symptoms. SLE patients have increased infective diathesis, and infections are a very important cause of death in these patients. Infections can sometimes mimic the signs and symptoms of SLE. Thus, it is important to recognize that infection can induce a lupus flare-up or can be difficult to distinguish from a lupus flare-up. We describe a 36-year-old female patient with SLE, who presented with skin lesions and pancytopenia, and clinical manifestations similar to a flare-up of SLE. Bone marrow examination revealed infection with Mycobacterium avium complex (MAC). The patient had no history or clinical evidence of pulmonary involvement. This patient is the first case of invasive bone marrow MAC infection in SLE. With this unique case, we would like to emphasize that SLE patients can also be infected by non-tuberculous mycobacteria, and that bone marrow examination for tuberculosis as well as for non-tuberculosis mycobacteria should be considered in SLE patients with refractory pancytopenia.
系统性红斑狼疮（SLE）是一种具有广泛症状和体征的疾病。SLE 患者易感染，感染是这些患者死亡的一个非常重要的原因。感染有时可能模仿 SLE 的症状和体征。因此，重要的是要认识到感染可诱导狼疮发作，或者可能难以与狼疮发作区分。我们描述了一位 36 岁的女性 SLE 患者，她出现皮肤损伤和全血细胞减少，临床表现类似于 SLE 发作。骨髓检查显示感染了鸟分枝杆菌复合体（MAC）。该患者无肺部受累的病史或临床证据。该患者是首例 SLE 侵袭性骨髓 MAC 感染的病例。通过这个独特的病例，我们想强调 SLE 患者也可能感染非结核分枝杆菌，对于难治性全血细胞减少的 SLE 患者，应考虑进行骨髓结核和非结核分枝杆菌检查。
