Systemic Lupus Erythematosus Presenting With Febrile Illness and Hepatitis

Lupus hepatitis is a rare initial manifestation of systemic lupus erythematosus (SLE) and may present with abnormal liver function tests. Differentiating hepatic dysfunction related to SLE from other causes, particularly autoimmune hepatitis, is important because management and prognosis differ significantly depending on the underlying etiology. Liver biopsy may play a critical role in distinguishing lupus hepatitis from other causes of hepatic injury. We describe a case of a man with newly diagnosed SLE who presented with prolonged febrile illness and elevated transaminases.