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Livedo racemosa and thrombotic vasculitides of scalp in systemic lupus erythematosus
  1. Jui-Yun Lee1,
  2. Chang-Youh Tsai2,3,
  3. Hsien-Tzung Liao1,2,4
  1. 1 Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  2. 2 Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
  3. 3 Division of Immunology and Rheumatology, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
  4. 4 Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Dr Hsien-Tzung Liao, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; htliao{at}

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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 …

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  • Handling editor Josef S Smolen

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  • 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.