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Ben David R, Abu-Shakra M, Meirovitz M, Test T, Medvedev N, Sagy I. Paraneoplastic systemic lupus erythematosus associated with dysgerminoma: a case report and literature review. Intern Emerg Med 2024:10.1007/s11739-024-03790-6. [PMID: 39377884 DOI: 10.1007/s11739-024-03790-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 09/30/2024] [Indexed: 10/09/2024]
Abstract
Rheumatic paraneoplastic syndromes are rare and generally occur no longer than two years before diagnosis of the associated malignancy. Therefore, it can be an essential clue to occult malignancy. A healthy 18-year-old female with no underlying diseases was referred to the rheumatology clinic due to morning stiffness in her hands and a new rash on her fingers. Her labs showed a positive ANA, anti-double strand DNA antibody, anti-RNP, and anti-ribosomal P. Nine months after the diagnosis with SLE, the patient presented with elevated levels of lactate dehydrogenase. A total-body computed tomography scan revealed a solid mass in the pelvis. The pathological findings corresponded to a dysgerminoma tumor. Following surgical tumor removal and chemotherapy, the patient went into remission with both SLE and her oncology conditions, with no relapse of her lupus symptoms in a one-year follow-up. This case underscores the importance of considering malignancy in unexplained lupus symptoms, a crucial point for all physicians to be aware of. We identified 13 cases of paraneoplastic SLE in a literature review. In most cases, SLE is resolved after the tumor has been treated.
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Affiliation(s)
- Ran Ben David
- Internal Medicine Division, Soroka Univerity Medical Center, Beer-Sheva, Israel.
- Rheumatic Diseases Unit, Soroka University Medical Center, Beer Sheva, Israel.
| | - Mahmoud Abu-Shakra
- Internal Medicine Division, Soroka Univerity Medical Center, Beer-Sheva, Israel
- Rheumatic Diseases Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Mihai Meirovitz
- Unit of Gynecologic Oncology, Soroka Medical Center, Beer Sheva, Israel
| | - Tsafnat Test
- Clalit Health Services, Southern District, Beer-Sheva, Israel
- Department of Family Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Nikita Medvedev
- Clalit Health Services, Southern District, Beer-Sheva, Israel
- Institute of Pathology, Soroka University Medical Centre, Beer-Sheva, Israel
| | - Iftach Sagy
- Internal Medicine Division, Soroka Univerity Medical Center, Beer-Sheva, Israel
- Rheumatic Diseases Unit, Soroka University Medical Center, Beer Sheva, Israel
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