Systemic Lupus Erythematosus Masquerading as Disseminated Tuberculosis: Case Report in a Nigerian Adolescent

Abstract

Systemic lupus erythematosus (SLE) is a connective tissue disorder whose manifestations may mimic other common chronic diseases in children. In developing countries, its diagnosis is often delayed or missed leading to delay in instituting appropriate treatment and invariably high mortality. We report the case of A. B who was a 13‑year‑old girl referred from a peripheral hospital with chronic cough, weight loss, and dyspnea. She had signs of heart failure and developed depression as well as oliguria. The patient also had pleural effusion, but aspirate result was negative for Mycobacterium tuberculosis and cytology. She commenced antituberculous drugs and dexamethasone with other supportive care but died after 19 days on  admission. Serum assay was positive for antinuclear antibody. SLE is a potential masquerader of chronic diseases such as tuberculosis. Delay in  diagnosis and treatment is associated with poor outcome; hence, there is a need for high index of suspicion for early diagnosis with prompt initiation of appropriate treatment.

Keywords: Adolescent, systemic lupus erythematosus, tuberculosis