Jaber Mohanad, Muhtasib Loai, Qawasmeh Hebatallah, Thalji Mariam, Yaghmour Hiba Y, Hroob Hasan, Al-Zughayyar Ashraf, Dweik Majed
Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine.
Medical Intensive Care Unit, Al-Ahli Hospital, Hebron, Palestine.
Front Immunol. 2025 Oct 20;16:1610687. doi: 10.3389/fimmu.2025.1610687. eCollection 2025.
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production and systemic inflammation. Immunosuppressive treatment is often required to achieve remission. While opportunistic infection rates have risen in this patient population, cytomegalovirus is one of the most lethal opportunistic infections with fatal consequences. Herein, we report a case of an 18-year-old female patient with a two-year history of SLE complicated by lupus nephritis who presented with gastrointestinal symptoms while on immunosuppressive medication. She then developed a cascade of serious complications, including colitis, fulminant liver failure, acute pancreatitis, and pneumonitis, which progressed to disseminated intravascular coagulation (DIC). Detailed investigations were conducted, and the patient was diagnosed with disseminated cytomegalovirus infection. Multidisciplinary supportive management failed to save her life. Disseminated CMV infection is a rare but deadly condition in patients with SLE. This case emphasizes the importance of maintaining a high level of suspicion and considering CMV infection as a differential diagnosis in patients with SLE on immunosuppressive therapy who have obvious gastrointestinal symptoms. This allows for early detection, timely management, and administration of antiviral drugs, leading to improved overall patient health outcomes.
系统性红斑狼疮（SLE）是一种自身免疫性疾病，其特征为自身抗体产生和全身炎症。通常需要进行免疫抑制治疗以实现缓解。虽然该患者群体的机会性感染率有所上升，但巨细胞病毒是最致命的机会性感染之一，可导致致命后果。在此，我们报告一例18岁女性患者，有两年SLE病史并伴有狼疮性肾炎，在接受免疫抑制治疗期间出现胃肠道症状。随后她出现了一系列严重并发症，包括结肠炎、暴发性肝衰竭、急性胰腺炎和肺炎，并进展为弥散性血管内凝血（DIC）。进行了详细检查，患者被诊断为播散性巨细胞病毒感染。多学科支持治疗未能挽救她的生命。播散性巨细胞病毒感染在SLE患者中是一种罕见但致命的病症。该病例强调了保持高度怀疑的重要性，并将巨细胞病毒感染作为接受免疫抑制治疗且有明显胃肠道症状的SLE患者的鉴别诊断考虑因素。这有助于早期发现、及时处理并给予抗病毒药物，从而改善患者的总体健康结局。
