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Infectious facade of autoimmunity: when SLE masquerades as tuberculosis
  1. Debashis Priyadarshan Sahoo1,
  2. Bhupen Barman2,
  3. Md Jamil1,
  4. Gwenette Andrea War2,
  5. Annu Gupta1 and
  6. Ashwini Chikkannaswamy1
  1. 1General Medicine, All India Institute of Medical Sciences Guwahati, Guwahati, Assam, India
  2. 2Internal Medicine, All India Institute of Medical Sciences - Guwahati, Guwahati, Assam, India
  1. Correspondence to Debashis Priyadarshan Sahoo; hpydps{at}gmail.com

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterised by widespread inflammation affecting multiple organ systems. Its varied clinical manifestations often complicate diagnosis, as it can closely mimic other conditions, particularly infectious diseases such as tuberculosis. This case report describes a woman in her early 20s initially suspected of having disseminated tuberculosis and treated accordingly due to overlapping symptoms, including fever, night sweats, lymphadenopathy and bilateral exudative pleural effusion. Subsequent evaluation, however, confirmed a diagnosis of SLE based on clinical criteria and positive autoantibody results. The patient also presented with anaemia of chronic disease and elevated inflammatory markers. This case highlights the diagnostic difficulty of differentiating SLE from tuberculosis, particularly in regions with high tuberculosis prevalence. Comprehensive physical examination, thorough evaluation and consideration of autoimmune disorders are essential in such cases to ensure accurate diagnosis, guide appropriate treatment and prevent severe complications.

  • Tuberculosis
  • Systemic lupus erythematosus

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Footnotes

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: DPS, BB, MJ, GAW, AG and AC. The following authors gave final approval of the manuscript: BB. BB is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.