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Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by heterogeneous symptoms that can manifest in any organ, and often presents at a young age. Infectious mononucleosis (IM) is the acute clinical manifestation of Epstein–Barr virus (EBV). It is characterized by low-grad...

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Autores principales: Wang, Shifang, Wang, Shiyu, Singh, Shaleindra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517992/
https://www.ncbi.nlm.nih.gov/pubmed/32964755
http://dx.doi.org/10.1177/2324709620961613
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author Wang, Shifang
Wang, Shiyu
Singh, Shaleindra
author_facet Wang, Shifang
Wang, Shiyu
Singh, Shaleindra
author_sort Wang, Shifang
collection PubMed
description Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by heterogeneous symptoms that can manifest in any organ, and often presents at a young age. Infectious mononucleosis (IM) is the acute clinical manifestation of Epstein–Barr virus (EBV). It is characterized by low-grade fever, malaise, lymphadenopathy, splenomegaly, and occasionally symmetrical arthralgias. It has been proposed that EBV is a trigger for new-onset SLE, and patients with autoimmune disorders such as SLE are more likely to have recurrent IM infections. The patient, a 64-year old Caucasian female who’s only past medical history was hypertension, developed several months–long period of vague symptoms, including fatigue, malaise, nausea, and nonbilious vomiting with oral intake. She presented with symmetrical polyarthritis involving the hands and elbows, with no history of arthritis before this episode. At the 5-month follow-up, she presented with worsening arthritis bilaterally in her elbows and in her right knee. For several decades, there has been a theoretical association between EBV and SLE, with EBV thought to be one of the many possible triggers for development of SLE. Based on the disease course, we theorize that the patient’s IM and EBV infection led to development of SLE. A small fraction of SLE cases have been reported in literature to be associated with EBV. This case adds to that literature with EBV triggering development of SLE in a seemingly previously asymptomatic patient.
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spelling pubmed-75179922020-10-02 Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman Wang, Shifang Wang, Shiyu Singh, Shaleindra J Investig Med High Impact Case Rep Case Report Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by heterogeneous symptoms that can manifest in any organ, and often presents at a young age. Infectious mononucleosis (IM) is the acute clinical manifestation of Epstein–Barr virus (EBV). It is characterized by low-grade fever, malaise, lymphadenopathy, splenomegaly, and occasionally symmetrical arthralgias. It has been proposed that EBV is a trigger for new-onset SLE, and patients with autoimmune disorders such as SLE are more likely to have recurrent IM infections. The patient, a 64-year old Caucasian female who’s only past medical history was hypertension, developed several months–long period of vague symptoms, including fatigue, malaise, nausea, and nonbilious vomiting with oral intake. She presented with symmetrical polyarthritis involving the hands and elbows, with no history of arthritis before this episode. At the 5-month follow-up, she presented with worsening arthritis bilaterally in her elbows and in her right knee. For several decades, there has been a theoretical association between EBV and SLE, with EBV thought to be one of the many possible triggers for development of SLE. Based on the disease course, we theorize that the patient’s IM and EBV infection led to development of SLE. A small fraction of SLE cases have been reported in literature to be associated with EBV. This case adds to that literature with EBV triggering development of SLE in a seemingly previously asymptomatic patient. SAGE Publications 2020-09-23 /pmc/articles/PMC7517992/ /pubmed/32964755 http://dx.doi.org/10.1177/2324709620961613 Text en © 2020 American Federation for Medical Research https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Wang, Shifang
Wang, Shiyu
Singh, Shaleindra
Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman
title Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman
title_full Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman
title_fullStr Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman
title_full_unstemmed Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman
title_short Development of Systemic Lupus Erythematosus After Infectious Mononucleosis in a 64-Year-Old Woman
title_sort development of systemic lupus erythematosus after infectious mononucleosis in a 64-year-old woman
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517992/
https://www.ncbi.nlm.nih.gov/pubmed/32964755
http://dx.doi.org/10.1177/2324709620961613
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