Protein-caloric malnutrition and systemic lupus erythematosus

We report 5 patients with systemic lupus erythematosus (SLE) who presented with severe protein-caloric malnutrition that overshadowed the clinical picture of SLE. All 5 patients had severe anemia, extreme lymphopenia and hypoalbuminemia, but all 5 also had striking hypergammaglobulinemia with high titers of autoantibodies. These patients show that SLE may occur in subjects with endemic malnutrition and suggest that the production of autoantibodies in SLE patients overrules the requirements for the production of other proteins.