Kang MI, Kwon HC. Systemic lupus erythematosus in a 15-year-old female with multiple splenic nodules: A case report. World J Clin Cases 2024; 12(12): 2128-2133 [PMID: 38680264 DOI: 10.12998/wjcc.v12.i12.2128]
Corresponding Author of This Article
Hyeok Chan Kwon, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, No. 201 Manghyang-ro, Dongnam-gu, Cheonan-si 31116, South Korea. derui@naver.com
Research Domain of This Article
Rheumatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 26, 2024; 12(12): 2128-2133 Published online Apr 26, 2024. doi: 10.12998/wjcc.v12.i12.2128
Systemic lupus erythematosus in a 15-year-old female with multiple splenic nodules: A case report
Mi Il Kang, Hyeok Chan Kwon
Mi Il Kang, Division of Rheumatology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan-si 31116, South Korea
Hyeok Chan Kwon, Division of Rheumatology, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan-si 31116, South Korea
Author contributions: Kang MI and Kwon HC designed and performed the research; Kang MI and Kwon HC equally contributed towards writing and revising the paper.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyeok Chan Kwon, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, No. 201 Manghyang-ro, Dongnam-gu, Cheonan-si 31116, South Korea. derui@naver.com
Received: January 16, 2024 Peer-review started: January 16, 2024 First decision: February 6, 2024 Revised: February 9, 2024 Accepted: March 28, 2024 Article in press: March 28, 2024 Published online: April 26, 2024 Processing time: 91 Days and 5.2 Hours
Abstract
BACKGROUND
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease primarily affecting young females. SLE can invade any organ, and various forms of splenic invasion have been reported. Manifestations include splenomegaly and splenic infarction, rupture, and calcification. The study encountered a rare case of splenic involvement, with nodules of various sizes without calcifications or ruptures.
CASE SUMMARY
A 15-year-old girl presented with arthralgia, weight loss, fever, increased levels of inflammatory markers, and positive antinuclear antibody test results. The patient was diagnosed with SLE. She was asymptomatic while taking steroids and hydroxychloroquine. Ten months after discharge, the patient developed a fever and abdominal pain. Lupus enteritis was suspected, and abdominopelvic computed tomography (AP-CT) was performed. There were no specific findings in the gastrointestinal tract, but multiple splenic nodules were observed. Infection or hemangioma was considered; however, no specific radiological findings were observed. A biopsy of the spleen was performed to determine the possibility of malignancy. The histological findings of the spleen included extensive periarteriolar necrosis with hematoxylin bodies and numerous karyorrhectic debris. Based on the biopsy results, the patient was diagnosed with an SLE flare-up and was maintained on high-dose steroids and immunosuppressants.
CONCLUSION
As disease activity increased, multiple nodules in the spleen that were previously unseen were observed using AP-CT and histologically confirmed. Spleen invasion by SLE can appear in multiple nodular forms and patterns. Therefore, physicians should consider these findings when differentiating these nodules from infections and malignancies.
Core Tip: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease primarily affecting young females. Here, the study reports a rare case of a 15-year-old female with SLE. During follow-up, the patient developed splenic involvement with nodules of various sizes, which are not typical manifestations. The patient was diagnosed with an SLE flare-up and was maintained on high-dose steroids. The study emphasizes the importance of an accurate diagnosis and careful observation of rare splenic manifestations of SLE.
