Massive Generalized Lymphadenopathy Due to Systemic Lupus Erythematosus

Background: Massive generalized lymphadenopathy (MGL) as an initial manifestation of systemic lupus erythematosus (SLE) is rare. The Case: A previously healthy 18-year-old man presented with MGL for 1 month. Subsequently, he developed fever, hypertension, fluid overload, and left abdominal pain. He had hemoglobin 89 g/L, serum creatinine 168 umol/L, serum albumin 29 g/L, prolonged activated partial thromboplastin time, heavy proteinuria, and hematuria. Fused PET/CT scanning showed hypermetabolic peripheral and internal MGL with splenic and right kidney infarctions. Autoimmune tests showed very low serum complements 3 and 4 with high titers of ANA 1/640 (N: 1/40) and anti-dsDNA 666 IU/ml (N: In Conclusion: SLE can present with MGL.