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Coexisting systemic lupus erythematosus and sickle cell disease: a diagnostic and therapeutic challenge

Nader A Khalidi1, Harpinder Ajmani, John Varga

  • 1Section of Rheumatology, McMaster University, 240 James Street South, Hamilton, Ontario, Canada L8P 3B3. naderkhalidi@sympatico.ca

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 17, 2005
PubMed

Insights

Systemic lupus erythematosus (SLE) and sickle cell disease (SCD) can coexist, though rarely. Diagnosing SLE in SCD patients is challenging due to overlapping symptoms, potentially delaying crucial treatment.

Area of Science:

  • Rheumatology
  • Hematology
  • Internal Medicine

Background:

  • Systemic lupus erythematosus (SLE) and sickle cell disease (SCD) are prevalent disorders, particularly in Black populations.
  • The co-occurrence of SLE and SCD in a single patient is exceptionally rare.
  • This study investigates the complexities of managing patients with both conditions.

Observation:

  • Four cases of concurrent SLE and SCD are presented.
  • Patients exhibited diverse complications affecting musculoskeletal, central nervous system, and renal systems.
  • Clinical manifestations often overlapped between SLE and SCD.

Findings:

  • Diagnosing SLE in patients with SCD is frequently delayed due to overlapping symptoms.
  • A significant proportion of SCD patients (up to 23%) may present with antinuclear antibodies.
  • All reported patients had pre-existing SCD, but developed significant new complications attributed to SLE.

Implications:

  • Recognizing the diagnostic challenges is crucial for timely SLE diagnosis in SCD patients.
  • Increased awareness of potential SLE complications in SCD patients is warranted.
  • Further research is needed to elucidate the interplay between SLE and SCD and optimize patient management.

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