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One 50-year-old systemic lupus erythematosus male patient presented to our emergency room with a 2-month history of intermittent high fever and diffuse hair loss. On admission to our hospital, spiking fever up to 40°C, pancytopenia, hyperferritinemia 9091 ng/mL (normal range: 30–400 ng/mL in male) and impaired kidney function with heavy proteinuria 8.91 gm/day (normal range: less than 0.2 gm/day) were noted. After investigation with laboratory examination and bone marrow biopsy, macrophage-activated syndrome and lupus nephritis with nephrotic syndrome were noted. Serial serology results including hepatitis B virus, hepatitis C virus, HIV …
Handling editor Josef S Smolen
Contributors All authors contributed to one or more of the following aspects of the manuscript: conception, acquisition of data, drafting and revising the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.