Atypical systemic lupus erythematosus or Castleman's disease

Acta Clin Belg. 2004 May-Jun;59(3):161-4. doi: 10.1179/acb.2004.023.

Abstract

Collagen vascular diseases and malignancies have common systemic and immune features. We report a case of a 21 year old female patient with constitutional symptoms, polyserositis, spontaneous rupture of the spleen, leukocytoclastic vasculitis and acute renal failure. The tentative diagnosis of SLE was made because she developed a positive antinuclear factor (1/640), with anti-SSA antibodies and a positive lupus anticoagulans. Two months later a cervical lymphadenopathy occurred while recieving treatment with prednisolone. A lymph node biopsy revealed morphologic features of a SLE, similar to those observed in multicentric Castleman's disease (MCD). MCD is a distinct type of a lymphoproliferative disorder of unknown etiology. The difficulties in differential diagnosis of these two diseases are discussed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Castleman Disease / complications
  • Castleman Disease / diagnosis*
  • Castleman Disease / pathology
  • Diagnosis, Differential
  • Fatal Outcome
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / pathology
  • Lymph Nodes / pathology
  • Serositis / etiology