The clinical importance of lymphadenopathy in systemic lupus erythematosus

Lymphadenopathy (LAP) is a frequent and usually nonspecific feature of Systemic Lupus Erythematosus (SLE). In spite of the fact that LAP usually carries no risk to the patient, SLE patients with LAP were found to have higher disease activity levels. Besides the disease itself, other causes of LAP such as infections, immunological or malignant diseases must be considered in the differential diagnosis. LAP is a prominent clinical characteristic of Kikuchi-Fujimoto's disease which is associated with fever, arthralgia, and leukopenia, features also found in SLE. As the prognosis and treatment of KFD and SLE are different, it is important to differentiate these two entities. On the other hand, the increased risk of lymphoproliferative diseases in SLE was reported in several studies. Since there is a considerable overlap between the features of SLE and lymphoma, there can be a difficulty in diagnosing lymphoma in lupus patients. An increased awareness is recommended in dealing with SLE patients with LAP and careful clinical, laboratory and pathological evaluation are often needed in order to establish an accurate diagnosis.