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Systemic lupus erythematosus with haemophagocytosis and severe liver disorder
  1. E Maeshima,
  2. T Kobayashi,
  3. M Mune,
  4. S Yukawa
  1. Third Department of Internal Medicine, Wakayama Medical College, 811–1 Kimiidera, Wakayama City, Wakayama 641–0012, Japan
  1. Correspondence to:
    Dr E Maeshima;

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We report the case of a 30 year old woman who was diagnosed with systemic lupus erythematosus (SLE)1 and had received prednisolone and cyclosporin A (CsA). In November 1999 a haematological examination showed a slight increase in transaminases. With no improvement in transaminase values, CsA was discontinued, and prednisolone was continued at 20 mg/day. Because of general malaise, she was admitted in January 2000.


A haematological examination showed a marked decrease in white blood cells (WBC) to 1.4×109/l, with a slight anaemia, but platelets were within the normal range. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were considerably increased to 617 U/l (normal 13–33) and 350 U/l (normal 6–27), respectively. Ferritin was also increased to 2306 ng/ml (normal 5–178). C reactive protein (CRP) was increased to 7.9 mg/l (normal 0–4). …

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