A case of fulminant systemic lupus erythematosus complicated by severe aspergillar septicemia confirmed by pathologic findings
Wang, Q.L.; Yin, J.N.; Han, Z.R.
Chinese Medical Journal 99(6): 493-497
1986
ISSN/ISBN: 0366-6999 PMID: 3100192 Document Number: 270516
A female young worker, single, aged 20 years, had an attack of systemic lupus erythematosus evolving rapidly into lupus encephalopathy manifested by psycho-neurologic disorders. The clinical features were typical with fever, arthralgia, proteinuria, oliguria, heart enlargement, pleural effusion and abnormal liver function (Zntt 40 u, GPT 75 u), hypergammaglobulinemia, hypoproteinemia with A/G inversed. Anti-DNA Ab positive. Typical facial butterfly erythema was seen. At the last stage of the disease course, auditory and depressive hallucination with nervous disorders following soon appeared and finally the patient died on March 15, 1984 in deep coma. Autopsy performed 48 hours post-mortem, revealed typical wire-loop in the GBM, early stage Libman-Sack syndrome, bleeding due to duodenal ulcer, wedge shape lesion in the left kidney, upper lobe of the right lung, and on the orbital surface of the frontal lobe of the brain, bronchial mucomembrane damage and a large amount of filamentous fungi were seen in the lesions in the brain, kidney, and lung. These pathologic findings confirmed aspergillar septicemia undiscovered during life as the final cause of death.