Pseudo-SLE by human immunodeficiency virus infection.

Area of Science:

• Infectious Diseases
• Immunology
• Nephrology

Background:

• Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can predispose patients to infections.
• Opportunistic infections can complicate immunosuppressive therapy for autoimmune conditions.
• Disseminated Mycobacterium avium complex (MAC) infection is a serious opportunistic infection, particularly in immunocompromised individuals.

Observation:

• A 61-year-old woman presented with prolonged fever and recurrent opportunistic infections during SLE treatment.
• Renal biopsy confirmed Type-IV nephritis, and serological findings supported the SLE diagnosis.
• Colonoscopy and liver biopsy revealed disseminated MAC infection.

Findings:

• Subsequent testing confirmed the patient was positive for Human Immunodeficiency Virus (HIV).
• The clinical presentation suggested that the initial symptoms were manifestations of undiagnosed HIV infection.
• MAC infection occurred in the context of advanced immunosuppression secondary to HIV.

Implications:

• This case highlights the importance of considering HIV in patients with SLE presenting with opportunistic infections, especially disseminated MAC.
• Early diagnosis of HIV is crucial to prevent severe opportunistic infections and manage both conditions effectively.
• Integrated management strategies are needed for patients with co-existing autoimmune diseases and HIV.