AimTo analyze the clinical features of lupus-like tuberculosis (TB). MethodsThree cases of TB imitating systemic lupus erythematosus (SLE) flare were collected in our hospital. Based on literature review, there are only 3 reports of TB resembling lupus flare rather than SLE per se. ResultsThe 3 cases of lupus mimickers, with a mean age of 30.3 years, ranging from 27 to 32 years, had atypical features of SLE, namely no typical butterfly erythema, lupus hair, alopecia or proteinuria, similar to the patients reported in the 3 previously mentioned studies. Emergence of different autoantibodies like anti-nuclear antibodies, anti-double-stranded DNA, anti-nucleosome antibodies, and anti-histone antibodies could occur in TB, mostly as an epiphenomenon. In patients with specific serological anti-Sm and hypocomplementemia, active TB cannot be easily ruled out. The presence of autoantibodies neither altered the clinical manifestations and radiographic findings of active TB, nor were detectable after infections are resolved. The resistance of the SLE manifestations to the steroid and immunosuppressive treatment suggests the contribution of an infectious disease. ConclusionTB stimulated the production of autoantibodies, with shared affinity for mycobacteria and human antigens, which may have led to lupus mimickers.
基金:
National Natural Science Foundation of
China, Grant/Award Number: 81871292;
the Key Research and Development (R&D)
Projects of Shanxi Province, Grant/Award
Number: 201803D31136
第一作者单位:[1]Shanxi Med Univ, Shanxi Bethune Hosp, Tongji Shanxi Hosp, Shanxi Acad Med Sci,Hosp 3,Dept Rheumatol & Immuno, Taiyuan, Peoples R China[2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[1]Shanxi Med Univ, Shanxi Bethune Hosp, Tongji Shanxi Hosp, Shanxi Acad Med Sci,Hosp 3,Dept Rheumatol & Immuno, Taiyuan, Peoples R China[2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China[*1]Shanxi Med Univ, Shanxi Bethune Hosp, Tongji Shanxi Hosp, Shanxi Acad Med Sci,Hosp 3, Taiyuan 030032, Peoples R China
推荐引用方式(GB/T 7714):
Liu Yang,Che Guozhu,Liu Ying,et al.Tuberculosis mimicking the onset of systemic lupus erythematosus flare: Case based review[J].INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES.2023,26(6):1143-1148.doi:10.1111/1756-185X.14585.
APA:
Liu, Yang,Che, Guozhu,Liu, Ying&Xu, Ke.(2023).Tuberculosis mimicking the onset of systemic lupus erythematosus flare: Case based review.INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES,26,(6)
MLA:
Liu, Yang,et al."Tuberculosis mimicking the onset of systemic lupus erythematosus flare: Case based review".INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES 26..6(2023):1143-1148