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Visceral leishmaniasis resembling systemic lupus erythematosus
  1. P V Voulgari1,
  2. G A Pappas1,
  3. E N Liberopoulos1,
  4. M Elisaf1,
  5. F N Skopouli2,
  6. A A Drosos1
  1. 1Department of Internal Medicine, Medical School, University of Ioannina, Greece
  2. 2Department of Nutrition and Dietetics, University of Harokopion, Athens, Greece
  1. Correspondence to:
    Professor A A Drosos
    Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece; adrososcc.uoi.gr

https://doi.org/10.1136/ard.2003.014480

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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.

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    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 …

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