Baroudi Maen Nizam, Joudeh Anwar I, Alattiya Mohammed Kays, Lutf Abdo Qaid Ahmed, Abuzaid Hassan, Mahdi Salah
Department of Internal Medicine, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Internal Medicine, Collage of Medicine, Qatar University, Doha, Qatar.
Immun Inflamm Dis. 2025 Jan;13(1):e70083. doi: 10.1002/iid3.70083.
Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multisystemic involvement and unclear etiology. Although SLE could be linked to multiple neuropsychiatric manifestations, the co-occurrence of anorexia nervosa was only described through a few case reports that mainly affected children and adolescents.
a 40-year-old Filipina woman presented to hospital with a 3-day history of agitation, anorexia and auditory hallucinations. She also had restrictive dietary habits with substantial weight loss and excessive fear of weight gain for the past several months. Her medical history was also noticeable for a 3-month history of erythematous non-itchy skin rash. On examination, the patient was pale and underweight. She had angular stomatitis, bilateral exophthalmos, and diffuse goiter. Skin examination revealed diffuse scaly and erythematous rash over the neck and upper torso with post-inflammatory skin discoloration. Laboratory investigations showed pancytopenia, high serum creatinine, and +1 proteinuria. Further workup confirmed thyrotoxicosis due to Graves disease as well as having multiple positive autoantibodies including antinuclear antibody (ANA) which were suggestive for SLE. A subsequent kidney biopsy demonstrated class IV diffuse lupus nephritis. The patient was treated successfully with intravenous pulse steroid therapy, rituximab, and antithyroid medications with no residual symptoms or laboratory abnormalities.
The concurrence of anorexia nervosa with SLE and the complete resolution of anorexia nervosa symptoms with immunosuppressive therapy suggest common autoinflammatory pathogenesis for both conditions. Further research is needed to elucidate any potential association between SLE and anorexia nervosa.
系统性红斑狼疮（SLE）是一种复杂的自身免疫性疾病，累及多个系统，病因不明。虽然SLE可能与多种神经精神表现有关，但神经性厌食症与之并存的情况仅通过少数主要影响儿童和青少年的病例报告有所描述。
一名40岁的菲律宾女性因3天的烦躁、厌食和幻听症状入院。在过去几个月里，她还存在饮食限制习惯，体重显著减轻，且过度害怕体重增加。她还有一段3个月的非瘙痒性红斑皮疹病史，这在她的病史中也很明显。检查时，患者面色苍白且体重过轻。她有口角炎、双侧眼球突出和弥漫性甲状腺肿。皮肤检查发现颈部和上半身有弥漫性鳞屑性红斑皮疹，伴有炎症后皮肤色素沉着。实验室检查显示全血细胞减少、血清肌酐升高和蛋白尿（+1）。进一步检查证实患有格雷夫斯病导致的甲状腺毒症，以及包括抗核抗体（ANA）在内的多种自身抗体呈阳性，提示患有SLE。随后的肾脏活检显示为IV级弥漫性狼疮性肾炎。患者通过静脉注射脉冲类固醇疗法、利妥昔单抗和抗甲状腺药物成功治愈，无残留症状或实验室异常。
神经性厌食症与SLE并存，且免疫抑制治疗可使神经性厌食症症状完全缓解，这表明这两种疾病存在共同的自身炎症发病机制。需要进一步研究以阐明SLE与神经性厌食症之间的任何潜在关联。
