Generalized lymphadenopathy as the first clinical manifestations of systemic lupus erythematosus–A case report

Generalized lymphadenopathy is a non-specific symptom of many diseases including infections, inflammations, malignancies, or autoimmune diseases. The presence of lymphadenopathy in systemic lupus erythematosus (SLE) is often associated with active disease and it’s rarely present without SLE symptoms. We presented a case of 24 years old postnatal female who experienced of prolonged fever, weight loss, constitutional symptoms, and generalized lymphadenopathy for two months. In view of no suggestive symptoms of infections, connective tissue disease and other malignancies, our major concern was lymphoma. However, over time, diagnosis of SLE was made based on late manifestations of musculoskeletal, hematological, neuropsychiatric, and renal symptoms of lupus supported by positive autoimmune investigations. This case highlighted how SLE first manifests as generalized lymphadenopathy followed by late manifestations of other symptoms. The vague symptoms of SLE make the diagnosis challenging.