Affiliation:
1. Student Research Committee Faculty of Medicine, Medical University of Qom Qom Iran
2. Clinical Research and Development Center Shahid Beheshti Hospital, Qom University of Medical Sciences Qom Iran
3. School of Medicine Shahid Beheshti Hospital, Qom University of Medical Sciences Qom Iran
Abstract
Key Clinical MessageClinicians should carefully consider generalized lymphadenopathy, particularly post viral infections, as one of the possible systemic lupus erythematous (SLE) first signs regarding unusual joint involvements such as sacroiliitis. Late diagnosis of this autoimmune inflammatory disease, could lead to irreversible morbidity and higher mortality.AbstractLymphadenopathy could represent various etiologies, including infections, malignancies, and rheumatologic diseases. SLE is known as the great mimicker which could be presented with different first manifestations. We report a 42‐year‐old woman in the acute phase of Epstein–Barr infection, admitted with polyarticular peripheral arthritis, sacroiliitis, and generalized lymphadenopathy. She had no similar history or taken unpasteurized dairy. Nodes were soft, mobile, and tender without skin change on top. During the process, she was diagnosed with SLE and discharged with prednisolone 30 mg/day and hydroxychloroquine 400 mg/day. After 2 weeks of follow‐up, all lymphadenopathy and symptoms were diminished. This case underscores the thousand faces innate of SLE. Clinical awareness would lead to an accurate diagnosis and early intervention.