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This case report aims to highlight the diagnostic challenges of systemic lupus erythematosus (SLE) amidst viral seropositivity.

June 19, 2026Open Access

When Viral Seropositivity Obscures Autoimmunity: Multisystem SLE with Concurrent CMV Positivity in an Immunocompetent Patient

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Randomized trial shows the challenges of diagnosing lupus in the presence of viral infections, suggesting vigilant evaluation is needed.

This case report aims to highlight the diagnostic challenges of systemic lupus erythematosus (SLE) amidst viral seropositivity.
Detailed clinical evaluation of a 28-year-old woman presenting with multisystem symptoms.
Treatment with valganciclovir for suspected active CMV infection due to high serological levels.
Diagnosis of SLE established following evaluation of clinical manifestations and laboratory findings.
Initial treatment for CMV led to transient improvement but caused severe liver enzyme elevations exceeding 900 U/L after relapse.
Active SLE was confirmed, highlighting it as the primary cause of her multisystem symptoms, despite high CMV serology.
CMV positivity was determined to be concurrent but non-causal, emphasizing the need for careful differential diagnosis.

Samprith et al. (2026) studied this question.

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June 19, 2026Open Access

View Full Paper

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Authors

Randomized trial shows the challenges of diagnosing lupus in the presence of viral infections, suggesting vigilant evaluation is needed.

This case report aims to highlight the diagnostic challenges of systemic lupus erythematosus (SLE) amidst viral seropositivity.
Detailed clinical evaluation of a 28-year-old woman presenting with multisystem symptoms.
Treatment with valganciclovir for suspected active CMV infection due to high serological levels.
Diagnosis of SLE established following evaluation of clinical manifestations and laboratory findings.
Initial treatment for CMV led to transient improvement but caused severe liver enzyme elevations exceeding 900 U/L after relapse.
Active SLE was confirmed, highlighting it as the primary cause of her multisystem symptoms, despite high CMV serology.
CMV positivity was determined to be concurrent but non-causal, emphasizing the need for careful differential diagnosis.

Samprith et al. (2026) studied this question.

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