Bharti Anju, Meena Lalit Prashant
Department of Pathology, King George Medical University, Lucknow 226003, India.
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Case Reports Immunol. 2014;2014:737453. doi: 10.1155/2014/737453. Epub 2014 Nov 20.
Background. Systemic lupus erythematosus (SLE) is an autoimmune disease which is known to present with a wide variety of clinical manifestations. Case Report. A 15-year-old male presented with complaints of moderate grade fever and generalized body swelling. There was no history of cough, weight loss, joint pain, oral ulcerations, skin rash, photosensitivity, loss of hair, pain abdomen, jaundice, or any significant illness in the past. Contrast enhanced computerized tomography of the abdomen revealed hypodense lesions in both liver and spleen (without contrast enhancement), suggestive of granulomas along with few retroperitoneal and mesenteric lymph nodes. On the basis of immunological tests and renal biopsy report, SLE with hepatosplenic granulomatosis diagnosis was made. He was given pulse methylprednisolone 500 mg, for 3 days and he showed dramatic improvement clinically. Conclusion. Hepatic and splenic granulomas are not common in SLE, but this should be kept in differential diagnosis.
背景。系统性红斑狼疮(SLE)是一种自身免疫性疾病,已知会出现多种临床表现。病例报告。一名15岁男性,主诉中度发热和全身肿胀。既往无咳嗽、体重减轻、关节疼痛、口腔溃疡、皮疹、光敏性、脱发、腹痛、黄疸或任何重大疾病史。腹部增强计算机断层扫描显示肝脏和脾脏均有低密度病变(无造影剂增强),提示肉芽肿,伴有少量腹膜后和肠系膜淋巴结。根据免疫学检查和肾活检报告,诊断为伴有肝脾肉芽肿病的SLE。给予其静脉注射甲泼尼龙500毫克,持续3天,临床症状显著改善。结论。肝脾肉芽肿在SLE中并不常见,但应列入鉴别诊断。