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25 March 2013

An interesting case of systemic lupus erythematosus presenting with hypercalcemia: A diagnostic dilemma

Abdul Halim Abdul GaforBEF, Rizna Abdul CaderBE, Srijit DasEF, Noraidah MasirE, Fadilah Abdul WahidBE

DOI: 10.12659/AJCR.883849

Am J Case Rep 2013; 14:83-84

Abstract

Background: Hypercalcemia is common in primary hyperparathyroidism malignancies and even in tuberculosis. Interestingly, systemic lupus erythematosus (SLE) rarely presents with hypercalcemia.
Case Report: We describe an interesting case of SLE in a patient who was otherwise thought to have either tuberculosis or a malignancy. The patient initially presented with feeling unwell, with generalized lymphadenopathy, bilateral pleural effusion, and bilateral corneal calcium deposits secondary to severe hypercalcemia. The diagnosis of SLE was made based on positivity of antinuclear antibodies (ANA) and anti-dsDNA, the presence of serositis, lymphadenopathy, autoimmune hemolytic anemia, and constitutional symptoms. She was treated with steroids, with tremendous improvement in her general well-being, resolution of lymphadenopathy and pleural effusion, and normalization of her hemoglobin and serum calcium. The atypical presentation of SLE with hypercalcemia with pleural effusion is discussed.
Conclusions: SLE should be one of the differential diagnoses in patients presenting with severe hypercalcemia.

Keywords: atypical presentation, hypercalcaemia, systemic lupus erythematosus

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923