In fact, authors note, blood dyscrasias are among the classification criteria of SLE. As an autoimmune condition, lupus has a diverse range of presentations and complications, including hematological abnormalities. Systemic lupus erythematosus is characterized by multiorgan involvement and the presence of autoantibodies. Follow-up with rheumatology and her primary physician is recommended.Ĭlinicians reporting this case 1 note that while systemic lupus erythematosus SLE has a variety of hematological manifestations, autoimmune myelofibrosis (AIMF) is rare and an unexpected presentation of SLE. C4 complement level is low at <3 mg/dL and C3 complement level is low at <63 mg/dL.Ĭlinicians ultimately determine that the patient developed systemic lupus erythematosus (SLE) following her initial presentation with autoimmune myelofibrosis (AIMF).įollowing treatment with intravenous Solu-Medrol, the patient is discharged on a steroid taper and Plaquenil. The patient's ANA titer is 1:2,560 with a homogeneous ANA pattern. However, rheumatology test results are positive for ANA, dsDNA antibody positive (15), rheumatoid factor (>1000), anti-Smith antibody, and SSA antibody. Test results for JAK2, MPL, CALR, and BCR-ABL are negative. Biopsy of a lymph node excised from her right groin shows mild follicular hyperplasia and paracortical expansion, and combined with immunostain findings, reactive lymph node is diagnosed. The patient undergoes further clinical assessment and is tested for antinuclear antibody (ANA), C3/C4, dsDNA, RF/CCP, ss-a, ss-b, and anti-Smith/RNP. Due to her anemia and intractable bone pain, the patient is admitted and rheumatologists are consulted. Testing also reveals elevations in sedimentation rate (>145 mm/hour) and ferritin level (710). The patient is discharged upon improvement of her clinical symptoms, although she is scheduled for further testing on an outpatient basis.
A peripheral smear shows poikilocytosis, microcytosis, and thrombocytosis. On admission to the inpatient ward, she receives a transfusion of 3 units of packed RBCs, which increases her hemoglobin to 7.5 g/dL. White blood cell count (WBC): 6.2 × 10 3 cells/μLĪlthough the patient has elevated lactate dehydrogenase (LDH) at 235 unit/L, her levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphate are all within normal limits.Red blood cell (RBC) count: 1.74 × 10 6 cells/μL.She is admitted for further laboratory testing, with the following results: Results of the clinical examination are unremarkable, expect for tachycardia on cardiovascular examination and pale conjunctiva on eye examination. She is calm, alert, and oriented to her surroundings.
0 kommentar(er)
