Misdiagnosis Analysis of One Elderly Patient with Systemic Lupus Erythematosus
YU Chuan-qi
ZONG Xue
ZHANG Chong
Abstract：Objective To discuss diagnosis and treatment of atypical systemic lupus erythematosus (SLE).Methods Clinical data of one SLE patient misdiagnosed as having lymph node tuberculosis was retrospectively analyzed.Results A 78-years-old male was admitted for foamy urine, increasing nocturia and repeat oral ulcer for one year.The patient was misdiagnosed as having lymph node tuberculosis for multiple mediastinal lymph nodes enlargement 3 years ago by result of lymph node biopsy, but symptoms failed to alleviate by anti-tuberculosis therapy after transferring to tuberculosis hospital.After admission in our hospital, results of antinuclear antibodies and anti-double-stranded DNA antibody were positive, and leukocytes, erythrocytes and hemoglobin levels in peripheral blood were decreased, and he had multiple organ injuries such as joint pain and repeat mouth ulcers, and then SLE was confirmed.Symptoms were relieved, and immunological indexes and leukocytes, erythrocytes and hemoglobin levels in peripheral blood were significantly improved after glucocorticoids treatment.Conclusion Part of SLE patients have atypical symptoms, especially in male patients, and therefore it is easily misdiagnosed.Clinicians should consider a diagnosis of SLE for elderly patients with unexplained decline in leukocytes, erythrocytes and hemoglobin levels in peripheral blood associated by oral ulcers, joint pain and lymph nodes enlargement, and immunological test should be performed as early as possible to avoid misdiagnosis and missed diagnosis.
Keywords：Systemic lupus erythematosuslymph node tuberculosisMaleMisdiagnosis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 28-31 )