Lupus mastitis as an early presentation of systemic systemic lupus

Article type : Case Report | تاریخ ثبت : 2018/01/12

  • Authors

    1. Khodashahi Mandana
    2. Azaminasab Asal Sadat
    3. Khodashahi Rozita
    4. Sarjamee Soroush
  • abstract

    Lupus mastitis, as an uncommon condition in systemic lupus erythematosus (SLE), is a subset of lupus panniculitis. Here, we report a 51-year-old woman who presented with fever, weight loss, low appetite, arthralgia, and cervical lymphadenopathy. She had experienced facial palsy six months earlier to presentation. On physical examination, besides submandibular and axillary lymphadenopathy, several lumps were palpated on the breasts bilaterally. There were no abnormalities on the skin or nipples. Mammography showed diffuse calcifications in both breasts. Further work-up revealed positive anti-double stranded DNA (anti-ds DNA), antinuclear antibody (ANA), anti-Sm antibody as well as leukopenia and lymphopenia, but normal platelet count. A core biopsy of the breast showed active inflammation, leukocyte infiltration, and fat necrosis without evidence of malignancy or fibrocystic changes. Prednisone and azathioprine were initiated for her. One month later, her symptoms had improved substantially and breast ultrasound exam showed decreased size of the lumps. Although lupus mastitis is an uncommon condition, especially when it declares the onset of SLE, it should be considered in the differential diagnosis of breast lesions in lupus patients.
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