Lymphadenopathy can be the initial manifestation of Systemic Lupus Erythematosus (SLE). This can result in diagnostic challenges because of the overlap in presentation with other infective or malignant conditions. We present the case of a 25-year-old woman who presented with generalized lymphadenopathy and constitutional symptoms. Initial workup pointed towards a diagnosis of non-Hodgkin’s lymphoma. However, the findings on immunohistochemistry and the partial resolution of the lymphadenopathy following steroid therapy were inconsistent with a malignant aetiology. Ultimately, a diagnosis of SLE was confirmed after the patient developed features of nephrotic syndrome and cutaneous manifestations typical of SLE. The repeat lymph node biopsy and autoimmune workup further supported the diagnosis. This case highlights the importance of developing a comprehensive list of differential diagnoses and the need to consider autoimmune aetiologies for patients presenting with generalized lymphadenopathy as the primary symptom.
Githaiga et al. (Tue,) studied this question.