Tuberculosis Mimicking the Onset of Systemic Lupus Erythematosus Flare: Case-Based Review

    February 2023 in “ International Journal of Rheumatic Diseases ”
    Yang Liu, Guozhu Che, Ying Liu, Ke Xu
    TLDR TB can mimic SLE symptoms, so doctors should consider TB in such cases.
    This case-based review examines three instances where tuberculosis (TB) mimicked the onset of systemic lupus erythematosus (SLE) flare. The patients, with an average age of 30.3 years, exhibited atypical SLE features, such as the absence of typical butterfly erythema, lupus hair, alopecia, or proteinuria. The study highlights that TB can stimulate the production of autoantibodies, which may lead to conditions resembling lupus. These autoantibodies, including anti-nuclear and anti-double-stranded DNA antibodies, appear as an epiphenomenon in TB cases. The presence of specific serological markers like anti-Sm and hypocomplementemia complicates the exclusion of active TB. The resistance of SLE-like symptoms to steroid and immunosuppressive treatments suggests an infectious disease's role in these manifestations.
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