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

This case-based review analyzed three instances of tuberculosis (TB) mimicking systemic lupus erythematosus (SLE) flare, with patients aged 27 to 32 years. These cases lacked typical SLE features like butterfly erythema, lupus hair, alopecia, or proteinuria. The study found that TB could induce the production of various autoantibodies, such as anti-nuclear and anti-double-stranded DNA antibodies, which are usually seen in SLE. However, these autoantibodies did not change the clinical or radiographic presentation of TB and were not present after the infection resolved. The resistance of SLE-like symptoms to steroid and immunosuppressive treatments suggested an infectious cause. The findings highlight the importance of considering active TB in patients with SLE-like symptoms, especially when specific serological markers and hypocomplementemia are present.