Linfadenopatia e lúpus eritematoso sistêmico

Ns, Neto; Kr, Bonfiglioli; Fm, Milanez; Pa, de Macêdo; Levy‐Neto, Maurício

doi:10.1590/s0482-50042010000100010

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…1 Lymphadenopathy is a benign finding in SLE commonly seen in young patients in any phase of the disease. 2 It can even antecede the diagnosis of SLE by many years, when the presence of auto antibodies or low complement levels cannot be detected. This will make early diagnosis of these cases difficult.…”

Section: Introductionmentioning

confidence: 99%

Unusual presentation and rare association of pediatric lupus

Krishna

Joseph

Krishnan

et al. 2023

Int J Contemp Pediatr

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Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune inflammatory disorder with diverse clinical manifestations which can lead to significant morbidity and mortality. Children and adolescents represent 15% to 20% of all patients with SLE. Childhood onset SLE is a rare disease with a prevalence of 3.5 to 8.8 per one lakh children. Localized or generalized lymphadenopathy may be an uncommon presenting feature of SLE. None of the classification criteria for SLE include lymphadenopathy as a criterion including the latest 2019 American college of rheumatology (ACR) / European league against rheumatism (EULAR) criteria. Nine-year-old female child presented with history of swelling on both sides of neck associated with fever and easy fatiguability for 2 months. Clinical examination revealed significant bilateral cervical and axillary lymph nodes with hepatomegaly. Excision biopsy of lymph node was suggestive of Kikuchi Fujimoto disease (KFD). As rare association of KFD with SLE is well described in literature, despite negative clinical features and laboratory findings of SLE, including an initial negative ANA IF test, we did a repeat ANA IF, complement (C3) level and dsDNA testing, all of which turned out to be positive, confirming the diagnosis of SLE. The child was started on hydroxychloroquine and oral steroids with dramatic response. During steroid tapering she developed a flare needing the addition of azathioprine. Currently she is in remission and is under follow up. Although rare, lupus lymphadenopathy may be a presenting feature of SLE. This can even antecede the diagnosis of SLE by many years, when the presence of auto antibodies or low complement levels are not detected and are associated with higher disease activity. This emphasizes the importance of high index of suspicion of SLE in cases of lymphadenopathy, enabling early diagnosis and management which is essential for preventing morbidity and mortality.

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Section: Introductionmentioning

confidence: 99%

Unusual presentation and rare association of pediatric lupus

Krishna

Joseph

Krishnan

et al. 2023

Int J Contemp Pediatr

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“…Nestes casos, são linfonodos reacionais que geralmente não ultrapassam dois centímetros e têm evolução com resolução autolimitada em aproximadamente duas semanas 5,6 . Os processos inflamatórios não infecciosos são menos comuns, mas devem ser lembrados quando associados a acometimentos multissistêmicos como doença de Kawasaki, Lúpus Eritematoso Sistêmico, Artrite Reumatoide e sarcoidose 7,8 . Dentre as massas congênitas podemos citar os cistos branquiais, cisto tireoglosso, anomalias vasculares (hemangiomas) e laringoceles, as quais normalmente são diagnosticadas na infância ou início da vida adulta.…”

Section: Introductionunclassified

Sistematização da propedêutica de massas cervicais – da Atenção Primária à Terciária

Ouverney,

Ribeiro,

Brandão

et al. 2022

Rev. APS

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Introdução: As massas cervicais são causas frequentes de encaminhamentos aos ambulatórios de otorrinolaringologia, muitas vezes com pouca abordagem na atenção primária à saúde. Sendo assim, a falta de uma rotina de manejo pode deixar o médico assistente inseguro e por vezes confuso quanto ao caminho de investigação a ser seguido, tornando-se necessário elaborar e aplicar uma rotina propedêutica que facilite e direcione o raciocínio clínico para diagnóstico de massas cervicais. Desenvolvimento: Através de revisão da literatura de artigos científicos coletados nos portais Medline, Lilacs e PubMed, utilizando descritores específicos como: necklump; head and neck cancer; epidemiology of head and neck cancer e consulta à literatura médica específica, foi elaborado um fluxograma para diagnóstico inicial das massas cervicais. Conclusão: Os autores elaboraram um fluxograma para a investigação e diagnóstico das massas cervicais de fácil memorização e aplicabilidade, adequado às condições estruturais de instituições públicas, e visando melhor atendimento, minimização de riscos, bem como qualificação dos profissionais. O fluxograma proposto visa ao diagnóstico diferencial entre doenças malignas e benignas, focando no que pode ser feito a nível de atenção primária à saúde.

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Guillain-Barré syndrome as first presentation of systemic lupus erythematosus: a rare manifestation complicated by IVIg-induced splenic infarct

2015

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A 44-year-old woman presented with progressively worsening neurological symptoms of 1 week duration. Physical examination revealed absent reflexes of the lower extremities and proximal muscle weakness, bilaterally. Cerebrospinal fluid analysis and electrophysiological studies were consistent with the diagnosis of Guillain-Barré syndrome (GBS) and the patient was started on intravenous immunoglobulin infusion. Along with positive neurological findings, rheumatological work up revealed elevated antinuclear antibody titres, positive double-stranded DNA and anti-Smith antibodies. These results, in conjunction with positive clinical findings, confirmed an underlying diagnosis of systemic lupus erythematosus (SLE). The patient's hospital course was complicated by an episode of severe left upper quadrant abdominal pain, fever, tachycardia and elevated inflammatory markers. CT scan of the abdomen revealed a splenic infarct following completion of IVIg infusion, making this a contributor to thrombus formation in the setting of an already thrombophilic state, and a rare complication of an approved method of treatment.

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Linfadenopatia e lúpus eritematoso sistêmico

Cited by 7 publications

References 13 publications

Unusual presentation and rare association of pediatric lupus

Unusual presentation and rare association of pediatric lupus

Sistematização da propedêutica de massas cervicais – da Atenção Primária à Terciária

Guillain-Barré syndrome as first presentation of systemic lupus erythematosus: a rare manifestation complicated by IVIg-induced splenic infarct

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