Visceral leishmaniasis or systemic lupus erythematosus flare?
Systemic lupus erythematosus (SLE) is a multisystem disorder characterised by B-cell hyperactivity with production of multiple autoantibodies. Fever in SLE may be caused by disease exacerbation or by infection. We report a patient of SLE that was later complicated by fever, pancytopenia, and massive splenomegaly. Corticosteroid therapy for SLE might have masked the underlying infection at earlier stage. Despite negative results of rk-39 test and bone marrow biopsy, a very high suspicion for visceral leishmaniasis (VL) led us to go for direct agglutination test (DAT) and polymerase chain reaction (PCR) for leishmanial antigen that revealed positive results. Moreover, significant improvement in clinical and biochemical parameters was noted on starting the patient on antileishmanial therapy.
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Sunny
S
Garg
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Mousumi
M
Kundu
Department of Radiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Amit Nandan Dhar
AN
Dwivedi
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Lalit Prashant
LP
Meena
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Neeraj
N
Varyani
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Asif
A
Iqbal
Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Kamlakar
K
Tripathi