Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Case Report

Volume 8, Number 11, November 2016, pages 819-823


Generalized Lymphadenopathy as Presenting Feature of Systemic Lupus Erythematosus: Case Report and Review of the Literature

Figures

Figure 1.
Figure 1. (a) CT neck with IV contrast demonstrating multiple enlarged supraclavicular lymph nodes. (b) CT chest with IV contrast demonstrating enlarged axillary lymph nodes. (c) CT abdomen and pelvis with IV contrast demonstrating a hypodense lesion in the periphery of the spleen measuring 1.4 × 3.4 × 3.6 cm. (d) CT abdomen and pelvis with IV contrast demonstrating multiple enlarged external iliac lymph nodes.
Figure 2.
Figure 2. (a) Right inguinal lymph node sample indicating numerous hyperplasic follicles (H&E, × 10 magnification). (b) Right inguinal lymph node sample indicating hyperplastic follicles with prominent germinal centers and reactive lymphocytosis (H&E, × 40 magnification).

Tables

Table 1. Initial Investigations
 
Complete blood countComprehensive metabolic panelInflammatory and coagulation profileEndocrinology and nutritionUrine analysis
*Abnormal values.
WBC: 3,700/µL*Glucose: 81 mg/dLCRP :0.50 < mg/dLTSH: 4.67 µU/mLColor: yellow
Neutrophils: 32.7%*BUN: 11 mg/dLESR: 132 mm/h*Free T4: 2.23 ng/dLAppearance: clear
Lymphocyte: 53.3%*Creatinine: 1.0 mg/dLD-dimer: 1,331 ng/mL*T3: 91.5 ng/dLSpecific gravity: 1.026
Monocytes: 11.7%Sodium: 135 mEq/LPT: 9.1 shCG: < 5.0 mIU/mLpH: 6.0
Eosinophils: 0.0%*Potassium: 3.8 mEq/LaPTT: 30.4 sFolate: 4.8 ng/mLProtein: ≥ 500 mg/dL*
Basophils: 2.3%Chloride: 110 mEq/L*LDH: 964 U/L*Vitamin B12: 886 pg/mLBlood: negative
Hemoglobin: 8.7 mg/dL*Bicarbonate: 25 mEq/LCholesterol: 364 mg/dL*Urobilinogen: < 2.0 EU
Platelets: 96/µL*Calcium: 7.0 mg/dLTriglycerides: 580 mg/dL*WBC: 3/HPF
Albumin: 1.5 g/dL*HDL: 44 mg/dLRBC: 3/HPF
Bilirubin: 0.3 mg/dLEpithelial cells: 3/HPF
AST: 33 U/LHyaline casts: 4/LPF
ALT: 23 U/LMucous threads: rare
ALP: 169 U/L*

 

Table 2. Connective Tissue Disease Panel
 
TestANAds-DNA antibodySM antibodyRNP antibodySS-ASS-BC3C4Rheumtoid factorAnti-CCP
Results1:1,280 homogenous38 U/mL> 8 AI> 8 AI< 1.0 AI< 1.0 AI< 40 mg/dL9.6 mg/dLNegativeNegative