Ben David Ran, Abu-Shakra Mahmoud, Meirovitz Mihai, Test Tsafnat, Medvedev Nikita, Sagy Iftach
Internal Medicine Division, Soroka Univerity Medical Center, Beer-Sheva, Israel.
Rheumatic Diseases Unit, Soroka University Medical Center, Beer Sheva, Israel.
Intern Emerg Med. 2025 Mar;20(2):349-355. doi: 10.1007/s11739-024-03790-6. Epub 2024 Oct 8.
Rheumatic paraneoplastic syndromes are rare and generally occur no longer than two years before diagnosis of the associated malignancy. Therefore, it can be an essential clue to occult malignancy. A healthy 18-year-old female with no underlying diseases was referred to the rheumatology clinic due to morning stiffness in her hands and a new rash on her fingers. Her labs showed a positive ANA, anti-double strand DNA antibody, anti-RNP, and anti-ribosomal P. Nine months after the diagnosis with SLE, the patient presented with elevated levels of lactate dehydrogenase. A total-body computed tomography scan revealed a solid mass in the pelvis. The pathological findings corresponded to a dysgerminoma tumor. Following surgical tumor removal and chemotherapy, the patient went into remission with both SLE and her oncology conditions, with no relapse of her lupus symptoms in a one-year follow-up. This case underscores the importance of considering malignancy in unexplained lupus symptoms, a crucial point for all physicians to be aware of. We identified 13 cases of paraneoplastic SLE in a literature review. In most cases, SLE is resolved after the tumor has been treated.
风湿性副肿瘤综合征罕见,通常在相关恶性肿瘤诊断前两年内出现。因此,它可能是隐匿性恶性肿瘤的重要线索。一名无基础疾病的健康18岁女性因手部晨僵和手指出现新皮疹而被转诊至风湿病诊所。她的实验室检查显示抗核抗体、抗双链DNA抗体、抗核糖核蛋白抗体和抗核糖体P抗体均呈阳性。诊断为系统性红斑狼疮9个月后,患者乳酸脱氢酶水平升高。全身计算机断层扫描显示盆腔有一个实性肿块。病理检查结果符合无性细胞瘤。手术切除肿瘤并化疗后,患者的系统性红斑狼疮和肿瘤病情均缓解,在一年的随访中狼疮症状未复发。该病例强调了在不明原因的狼疮症状中考虑恶性肿瘤的重要性,这是所有医生都应注意的关键点。我们在文献综述中确定了13例副肿瘤性系统性红斑狼疮病例。在大多数情况下,肿瘤治疗后系统性红斑狼疮会缓解。