Systemic lupus erythematosus and granulomatous lymphadenopathy

Shrestha, Devendra; Dhakal, Ajaya Kumar; Kc, Shiva Raj; Shakya, Arati; Shah, Subhash Chandra; Shakya, Henish

doi:10.1186/1471-2431-13-179

Cited by 22 publications

(18 citation statements)

References 20 publications

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“…In addition, abdominal lymph node enlargement could be the only imaging manifestation in patients with AILD [14]. It was reported that lymph nodes in patients with CTD were not limited to the body surface, but were in fact also distributed in the abdominal cavity [22]. However, in our study, abdominal lymph nodes tended to be most prevalent in patients with AILD (69.6%), significantly higher than in CTD patients (29.6%).…”

Section: Discussioncontrasting

confidence: 65%

The Enlargement of Abdominal Lymph Nodes Is a Characteristic of Autoimmune Liver Disease

Wang

Ran

et al. 2020

Mediators of Inflammation

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Background. The enlargement of lymph nodes is a common clinical sign in connective tissue disease (CTD) and viral hepatitis. In this research, we evaluated the incidence of enlarged lymph nodes in autoimmune liver diseases (AILD). Moreover, we identified the clinical significance of abdominal lymph node enlargement in AILD. Methods. The characteristics of abdominal lymph nodes, including their morphology and distribution, were assessed by ultrasonography and computed tomography in 125 patients with AILD, 54 with viral hepatitis, 135 with CTD, and 80 healthy controls. The pathological and laboratory results of 106 AILD patients were collected to analyze the association between lymphadenectasis and disease activity. Results. Enlargement of abdominal lymph nodes was found in 69.6% of patients with AILD, 63% of patients with viral hepatitis, 29.6% of patients with CTD, and 2% of healthy controls. Alkaline phosphatase (ALP), glutamate transpeptidase (GGT), and immunoglobulin M (IgM) levels were significantly increased in AILD patients with lymphadenectasis (LA) in contrast to patients without lymphadenectasis (NLA) (P<0.05). The pathological characteristics of inflammation, cholestasis, and focal necrosis were more common in the LA group than in the NLA group (P<0.05). As shown by multivariate logistic regression analysis, interface hepatitis (OR=3.651, P<0.05), cholestasis (OR=8.137, P<0.05), and focal necrosis (OR=5.212, P<0.05) were related to LA. Conclusions. The percentage of abdominal lymph node enlargement in AILD subjects was significantly higher than that in CTD subjects. Therefore, the enlargement of lymph nodes can represent a noninvasive indicator of histological and biochemical inflammation activity in AILD.

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Section: Discussioncontrasting

confidence: 65%

The Enlargement of Abdominal Lymph Nodes Is a Characteristic of Autoimmune Liver Disease

Wang

Ran

et al. 2020

Mediators of Inflammation

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“…Although SLE is a multisystemic autoimmune disease that courses with tissue damage arising from the immune system, the beginning with lymph node involvement is very rarely seen (1,(4)(5)(6) . The etiology is not known exactly.…”

Section: Discussionmentioning

confidence: 99%

“…SLE, which is a multisystemic disease, might be observed to show different clinical findings depending on the organ involvement. In a previous study, the initial symptoms of SLE patients were reported to be fever (67%), arthritis (61%), skin lesions (59%), and lymphadenopathy (LAP) (27.1%), another study reported that the most frequently seen initial symptoms were serositis, polyarthritis, and malar rash (4,5) .…”

Section: Intoductionmentioning

confidence: 99%

Lymphadenopathy of Systemic Lupus Erythematosus: A Case Presentation

Küçük¹,

Küçük²

2020

tjtfp

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Systemic lupus erythematosus (SLE) is an autoimmune disease that might be seen at any period of life regardless of age, gender, or race, but it most frequently affects young female patients. SLE might be observed to be together with the involvement of multiple organs coursing with skin, kidney, hematologic, and musculoskeletal involvement and responds well to the corticosteroids. Several symptoms and findings during the course of the disease might be dependent on the involvement of disease and they might also develop secondarily to the therapies applied. SLE is rarely seen together with lymphadenopathy (LAP) and this situation causes difficulties in diagnosis and treatment. The present case was a 32-year-old female patient, who has been diagnosed 13 years before, had no follow-up during the last 1.5 years, and presented to the family health center with the complaint of disease activation and swelling on the left side of neck. In medical examination, soft, mobile, and painless LAPs with approx. 2x1cm size were observed in both cervical regions. The one located on the right side was more remarkable. The patient stated that the swellings were there for 1.5 months and no reduction was observed in LAPs although she has taken various antibiotics. The patient was referred to Uşak Education and Research Hospital General Surgery Clinic with a referral note containing the necessary information with the preliminary diagnosis of SLE lymphadenopathy as a result of Anamnesis and physical examination taken by the patient who was admitted to the Family Health Center. All the procedures were followed by contacting the relevant branch physicians and patients at the hospital where the patient was admitted and treated. We had the opportunity to learn about the diagnostic procedures and treatments applied to the patient. The histopathologic diagnosis of LAP excision specimen was lupus lymphadenitis. The early diagnosis might be very difficult in these cases since the autoantibodies and low levels of complements cannot be detected. The present case is discussed here in the literature in order to emphasize that SLE is a pathology that should be considered in the differential diagnosis for the patients presenting with LAP.

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“…4 It is estimated 13-45% children with SLE are having lymphadenopathy. 5 Neither American College of Rheumatology criteria (ACR criteria) nor the Systemic Lupus International Collaborating Clinics (SLICC) criteria does not include lymphadenopathy as a diagnostic criterion. Lymphadenopathy is commonly seeing in children with SLE, but it is being a presenting feature is less frequent.…”

Section: Discussionmentioning

confidence: 99%

Systemic Lupus Erythematosus mimicking lymphoproliferative malignancy in a child

Munasinghe

Naotunna

Vithana

et al. 2019

J. Ruhunu Clin. Soc.

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Systemic Lupus Erythematosus (SLE) is a chromic autoimmune disease with multisystemic involvement. The estimated prevalence of SLE among children is 1-6/100000. Here we report a child who presented with generalized lymphadeopathy as the first manifestation of SLE. A 13 year old previously healthy girl presented with cervical lymphadenopathy and low grade remitting fever for 1 month duration. On examination she was found to have generalized lymphadenopathy and unremarkable rest of the clinical examination. Her basic haematological and biochemical parameters were normal. ESR was 110mm/hr and CRP was 6mg/dL. Ultrasound scan and Contrast CT of the abdomen and pelvis revealed extensive mediastinal, mesenteric, para-aortic, splenic hilar, bilateral axillary and inguinal lymphadenopathy suggestive of lymphoproliferative malignancy. However, her bone marrow and lymph node biopsies revealed reactive pattern. Meantime she developed a malar rash, oral ulcers and 2 episodes of generalized tonic-clonic convulsions. Her urinalysis revealed microscopic haematuria and sub nephrotic range proteinuria. Her ANA and dsDNA levels were positive. Her subsequent full blood count revealed severe bicytopenia, predominetly lymphopenia.The diagnosis of SLE was made and she was started on Hydroxychloroquine, high dose prednisolone and cyclophosphamide pulse therapy. The most common presenting symptoms of SLE in children include, constituitional symptoms, joint symptoms and haematological abnormalities. It is estimated 23-34% children with SLE are having lymphadenopathy. Though, generalized lymphadenopathy as the presenting symptom of SLE is uncommon, it should not be forgotten in order to avoid diagnostic delay.

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Systemic lupus erythematosus and granulomatous lymphadenopathy

Cited by 22 publications

References 20 publications

The Enlargement of Abdominal Lymph Nodes Is a Characteristic of Autoimmune Liver Disease

The Enlargement of Abdominal Lymph Nodes Is a Characteristic of Autoimmune Liver Disease

Lymphadenopathy of Systemic Lupus Erythematosus: A Case Presentation

Systemic Lupus Erythematosus mimicking lymphoproliferative malignancy in a child

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