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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown aetiology. B cell hyperactivity with production of multiple autoantibodies is the hallmark of the disease.1 On the other hand, such polyclonal B cell activation may occur in chronic infectious diseases. In this report we present a patient with visceral leishmaniasis who was diagnosed as having SLE and we discuss the clinical and laboratory findings which may discriminate between these two entities.
CASE REPORT
A 50 year old man presented in October 2001 with arthralgias, fatigue, weight loss, and low grade fever. Laboratory evaluation revealed haemoglobin 110 g/l, white blood cells 3.9×109/l with normal differential count, platelets 90×109/l, and erythrocyte sedimentation rate (ESR) 50 mm/1st h.
He was admitted to the hospital where physical examination disclosed mild splenomegaly. A laboratory investigation confirmed anaemia, leucopenia, and thrombocytopenia, increased ESR and C reactive protein (CRP) (table 1⇓). Renal, liver and thyroid …