Steroid-Induced Morbidity Mimicking Active Systemic Lupus Erythematosus

In two patients a transient illness was diagnosed as systemic lupus erythematosus and treated with corticosteroids. In each patient the original illness, which may not have been systemic lupus erythematosus, was shortly supplanted by partially masked infection, steroid-induced myalgia and arthralgia and steroid-related hypertension, edema, and proteinuria—all suggesting manifestations of this disease. These cases illustrate the potential iatrogenic hazards of this diagnosis, particularly the vicious cycle in which untoward steroid effects are misinterpreted as signs of active systemic lupus erythematosus and are treated with escalating steroid therapy.