Visceral leishmaniasis mimicking systemic lupus erythematosus

Bueno, Greyce Christine Lisboa; Koerich, Amanda Terra de Sá; Burg, Luciana Bonnassis; Kretzer, Sara Letícia; Moral, Joanita Ângela Gonzaga Del; Pereira, Ivânio Alves

doi:10.1590/0037-8682-0208-2018

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Case Report • Rev. Soc. Bras. Med. Trop. 52 • 2019 • https://doi.org/10.1590/0037-8682-0208-2018 linkcopy

Visceral leishmaniasis mimicking systemic lupus erythematosus

Authorship SCIMAGO INSTITUTIONS RANKINGS

Visceral leishmaniasis (VL), or kala-azar, a serious disease resulting from a systemic infection caused by a protozoan of the genus Leishmania, is potentially fatal to humans. According to data from Sistema de Informação de Agravos de Notificação (Brazil's Information System for Notifiable Diseases) from 2015 to 2016, 6,489 new cases were recorded in Brazil in 22 of the 27 federative units. In addition to typical clinical findings, VL may be associated with autoimmune phenomena, including simulating systemic lupus erythematosus (SLE). We present the first case of autochthonous VL mimicking SLE in Santa Catarina in southern Brazil.

Keywords:
Leishmaniasis; Kala-azar; Systemic lupus erythematosus

Exam	Reference value	Results
Hemoglobin, g/dl	13.2-18	9.1
Hematocrit	39-51%	28.5%
Leukocytes, /mm³	3800-11,000	2550
Segmented, /mm³	1700-7500	1453.5
Lymphocytes, /µl	1000-3500	561
Monocytes, /µl	200-920	127.5
Eosinophils, /µl	20-670	0
Basophils, /µl	0-130	25.5
Bands	0-5%	11%
Platelets, /mm³	150,000-440,000	86,000
C-reactive protein, mg/L	≤3	685
Lactate dehydrogenase, µ/L	81-234	845
Aspartate aminotransferase, µ/L	10-40	789
Alanine aminotransferase, µ/L	12-78	196
Rheumatoid factor, IU/ml	<15	292
Anti-CCP, U	Negative (<20)	46
Complement proteins
C3, mg/dl	90-180	62
C4, mg/dl	10-40	7.8
IgG, mg/dl	694-1618	3600
β₂-Microglobulin, ng/ml	609-2164	7367
Protein electrophoresis	10.3-18.2%	Hypergammaglobulinemia (44.2%)

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[TFN1] CCP: anti-cyclic citrullinated peptide.