Atypical systemic lupus erythematosus or Castleman's disease.
Collagen vascular diseases and malignancies have common systemic and immune features. We report a case of a 21 year old female patient with constitutional symptoms, polyserositis, spontaneous rupture of the spleen, leukocytoclastic vasculitis and acute renal failure. The tentative diagnosis of SLE was made because she developed a positive antinuclear factor (1/640), with anti-SSA antibodies and a positive lupus anticoagulans. Two months later a cervical lymphadenopathy occurred while recieving treatment with prednisolone. A lymph node biopsy revealed morphologic features of a SLE, similar to those observed in multicentric Castleman's disease (MCD). MCD is a distinct type of a lymphoproliferative disorder of unknown etiology. The difficulties in differential diagnosis of these two diseases are discussed.
Department of Immunology/Allergology/Reumatology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium. Immuno@ua.ac.be
K
K
Van de Voorde
H
H
De Raeve
C E
CE
De Block
N
N
Van Regenmortel
J F
JF
Van Offel
L S
LS
De Clerck
W J
WJ
Stevens
D000328:Adult; D001706:Biopsy; D005871:Castleman Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D012700:Serositis / Q000209:etiology