Title:Lymphadenopathy as a Prodrome for Systemic Lupus Erythematous

VOLUME: 17 ISSUE: 4

Author(s):Neha Kinariwalla*, Kelly Steed and Prabjot S. Mundi

Affiliation:Columbia University Vagelos College of Physicians & Surgeons, New York, Division of Rheumatology, James J Peters VA Medical Center, Bronx, New York, Division of Oncology, James J Peters VA Medical Center, Bronx, New York

Keywords:SLE, lymphadenopathy, case report, fever, lymph nodes, malaise.

Abstract:

Background: Lupus lymphadenopahy (LL) has an estimated incidence of 1% at diagnosis. Here, we report a case of systemic lupus erythematous which presented with a prodrome of generalized lymphadenopathy and fevers.

Case Presentation: A 41-year-old woman presented to the hospital with one month of fevers, chills, lymphadenopathy, abdominal pain, a bilateral upper extremity rash, and malaise. Physical exam was notable for tender, palpable posterior cervical lymph nodes that were mobile and about 1 cm in maximum diameter. After extensive infectious, hematologic, and autoimmune evaluations, a diagnosis of systemic lupus erythematous (SLE) was made and treatment with high-dose steroids and hydroxychloroquine which resulted in gradual improvement in symptoms.

Conclusion: Systemic lupus erythematous can present with a subtle prodrome of generalized lymphadenopathy. It is important for medical professionals to consider SLE in the differential in a patient with diffuse lymphadenopathy.