Infectious facade of autoimmunity: when SLE masquerades as tuberculosis

Area of Science:

• Rheumatology
• Infectious Diseases
• Internal Medicine

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with diverse clinical presentations.
• SLE symptoms can overlap with other conditions, notably infectious diseases like tuberculosis (TB).
• Differentiating SLE from TB is challenging, especially in high TB prevalence areas.

Purpose of the Study:

• To present a case report highlighting the diagnostic challenges in differentiating SLE from disseminated tuberculosis.
• To emphasize the importance of considering autoimmune disorders in patients with symptoms mimicking infectious diseases.

Main Methods:

• Case report of a young woman initially treated for disseminated tuberculosis.
• Diagnostic evaluation included clinical assessment, autoantibody testing, and inflammatory marker analysis.
• Comparison of clinical manifestations between SLE and tuberculosis.

Main Results:

• The patient presented with symptoms common to both SLE and TB, including fever, night sweats, lymphadenopathy, and pleural effusion.
• Initial suspicion of disseminated tuberculosis led to appropriate treatment.
• Subsequent evaluation confirmed SLE diagnosis based on clinical criteria and positive autoantibodies.
• Anemia of chronic disease and elevated inflammatory markers were noted.

Conclusions:

• This case underscores the diagnostic difficulty in distinguishing SLE from tuberculosis due to overlapping symptoms.
• A comprehensive approach including thorough physical examination and consideration of autoimmune etiologies is vital.
• Accurate diagnosis is essential for appropriate treatment and management of SLE to prevent severe complications.