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Lymphoma in a patient with systemic lupus erythematosus

Nature Clinical Practice Rheumatology volume 2, pages 570–574 (2006)Cite this article

Abstract

Background A 40-year-old woman with a 10-year history of systemic lupus erythematosus (SLE) presented with fever, lymphadenopathy and fatigue. Before that time, her SLE symptoms had been controlled with hydroxychloroquine, NSAIDs, and an occasional short course of moderate-dose prednisone. Two months before presentation, she experienced fevers ranging from 38.3 to 39.7 °C, but she had no specific symptoms that suggested local infection.

Investigations Physical examination, multiple blood cultures, and laboratory investigations that included the following tests: hemoglobin concentration; erythrocyte sedimentation rate; C-reactive protein level; serum lactate dehydrogenase level; aspartate aminotransferase level; alanine aminotransferase level; serum complement C3 and C4 levels; white-blood-cell count; platelet count; urinalysis; serum creatinine level; CT of the chest and abdomen; bone-marrow biopsy; serum electrophoresis; and tests for Epstein–Barr virus, cytomegalovirus, hepatitis B virus, hepatitis C virus, HIV-1, antinuclear antibodies, antibodies to Smith antigen, antibodies to double-stranded DNA, and antibodies to Ro and La.

Diagnosis Stage IVB diffuse large B-cell lymphoma with marrow and liver involvement concurrent with SLE.

Management The patient promptly underwent chemotherapy, receiving three courses of 3 mg/m2 vindesine on day 1, 1,500 mg/m2 cyclophosphamide and 80 mg/m2 doxorubicin on day 2, and 50 mg/m2 prednisolone on days 1–5.

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Acknowledgements

S Bernatsky, AE Clarke and CA Pineau would like to acknowledge the support of the Singer Family Fund for Lupus Research, Lupus Canada, CIHR, FRSQ, CAN, the National Cancer institute of Canada, NIH, the MUHC Research Institute and the Department of Medicine, MUHC, Montreal General Hospital.

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Authors and Affiliations

  1. Canadian Arthritis Network (CAN) Scholar at the McGill University Health Centre (MUHC) Research Institute and Department of Medicine, Canadian Institutes for Health Research (CIHR) and Fonds de la recherche en santé du Québec (FRSQ) Investigator, Montreal, Québec, Canada

    Sasha Bernatsky

  2. University, Feinberg School of Medicine Chicago, Illinois, USA

    Rosalind Ramsey-Goldman

  3. current President of the Systemic Lupus International Collaborating Clinics,

    Rosalind Ramsey-Goldman

  4. MUHC,

    Silvy Lachance & Ann E Clarke

  5. CIHR Investigator and Associate Professor at the McGill University,

    Silvy Lachance & Ann E Clarke

  6. co-direct the MUHC Lupus Clinic, Montreal, Québec, Canada

    Christian A Pineau & Ann E Clarke

Authors
  1. Sasha Bernatsky
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  2. Rosalind Ramsey-Goldman
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  3. Silvy Lachance
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  4. Christian A Pineau
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  5. Ann E Clarke
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The authors declare no competing financial interests.

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Bernatsky, S., Ramsey-Goldman, R., Lachance, S. et al. Lymphoma in a patient with systemic lupus erythematosus. Nat Rev Rheumatol 2, 570–574 (2006). https://doi.org/10.1038/ncprheum0295

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