Liu Chenxi, Pan Ci, Jin Yingying, Huang Hua, Ding Fei, Xu Xuemei, Bao Shengfang, Han Xiqiong, Jin Yanliang
Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Pediatr. 2024 Mar 1;12:1348342. doi: 10.3389/fped.2024.1348342. eCollection 2024.
Patients with systemic lupus erythematosus (SLE) are at a higher risk of developing cancer, particularly hematological malignancies such as lymphoma and leukemia. However, existing studies on this topic that assess cancer incidence following SLE diagnosis are limited. In addition, SLE can be diagnosed after cancer, although such cases in children have been rarely reported.
We present the case of a 2.6-year-old boy who presented to our institute with fever and abdominal pain. His physical examination revealed a periumbilical mass, which was pathologically diagnosed as Burkitt's lymphoma. Autologous stem cell transplantation was performed to consolidate the effect of chemotherapy and reduce the risk of cancer relapse. He was diagnosed with SLE 5 years later, following the presentation of a fever with rash, positive autoantibodies, decreased complement, and kidney involvement. At the final follow-up, the patient was still alive and showed no recurrence of Burkitt's lymphoma or disease activity of SLE.
Despite the low frequency of SLE in children with lymphoma, cancer and SLE may be induced by a common mechanism involving B-cell cloning and proliferation. Therefore, hematologists and rheumatologists should be aware of the occurrence of these two conditions during patient follow-up.
系统性红斑狼疮(SLE)患者患癌症的风险更高,尤其是淋巴瘤和白血病等血液系统恶性肿瘤。然而,现有评估SLE诊断后癌症发病率的相关研究有限。此外,SLE也可能在癌症之后被诊断出来,尽管儿童中的此类病例鲜有报道。
我们报告一例2.6岁男孩,因发热和腹痛前来我院就诊。体格检查发现脐周肿块,病理诊断为伯基特淋巴瘤。进行了自体干细胞移植以巩固化疗效果并降低癌症复发风险。5年后,他出现发热伴皮疹、自身抗体阳性、补体降低及肾脏受累,随后被诊断为SLE。在最后一次随访时,患者仍然存活,未出现伯基特淋巴瘤复发或SLE疾病活动。
尽管淋巴瘤患儿中SLE的发病率较低,但癌症和SLE可能由涉及B细胞克隆和增殖的共同机制诱发。因此,血液科医生和风湿科医生在患者随访期间应留意这两种疾病的发生。