Abstract
A 43-year-old female was first diagnosed as having rheumatoid arthritis (RA) because of polyarthritis. She was treated with non-steroid anti-inflammatory drugs, Salazosulphapyridin and Thiopronin. Subsequently lymphnode swelling and muscular weakness in the neck appeared, accompanied by high fever. On admission to Ida Kawasaki Metropolitan Hospital, the most likely diagnosis was thought to be polymyositis or MCTD, because of the muscular weakness, elevation of myogenetic enzyme and positive anti-n-RNP antibody. Later, a diagnosis of systemic lupus erythematosus (SLE) was strongly suspected because of positive antinuclear antibodies, positive LE cell phenomenon and high level of anti-DNA antibody. Finally, the diagnosis of SLE was confirmed by cervical lymphnode biopsy showing necrotizing lymphadenitis with a hematoxylin bodies. This case suggested that lymphnode biopsy may be a useful tool to diagnose SLE in such patients with lymphadenopathy.
