Systemic lupus erythematosus with secondary Sjögren’s syndrome mimicking hematologic malignancy

Abstract

A 43-year-old female experienced significant weight loss over a period of 6 months.  The physical examination revealed mild anemia and lymphadenopathy in the left cervical region (0.5 cm) and left axillary region (2 cm). Mild splenomegaly was suggested by increased splenic dullness. The blood tests showed anemia and an elevation of the globulin level. The thoracic and abdominal CT scans showed ground glass opacities in both lower lung fields and generalized lymphadenopathies, suggesting lymphoma.  The pathological reports from the bone marrow, axillary lymph node, and liver revealed no malignant involvement. The immunologic tests were compatible with systemic lupus erythematosus with secondary Sjögren’s syndrome. After treating with corticosteroids, hydroxychloroquine, artificial tears, and saliva substitutes, the patient’s symptoms improved, and her weight returned to normal. This case highlights the possibility of autoimmune diseases showing similar symptoms to hematologic malignancies. Therefore, physicians must be aware of autoimmune diseases to provide patients with accurate treatment and improve their overall well-being.