A Case of Systemic Lupus Erythematosus diagnosed on bone marrow aspiration

Abstract

Abstract: Lupus erythematosus (LE) cell phenomenon was demonstrated in patients with systemic lupus erythematosus (SLE) in 1948. Now-a-days, antinuclear antibody testing (ANA) including the specific anti-double stranded DNA and anti-Sm antibody, are the mandatory tests for the diagnosis of SLE. We report a case of a 30 year old female in whom bone marrow aspiration was performed during the investigative workup for pyrexia of unknown origin. The observation of LE cells in direct bone marrow smears (without the use of anticoagulant) raised the suspicion of SLE which was later confirmed on antinuclear antibody testing. This case emphasizes the fact that a good morphological observation of marrow aspirates can provide crucial clues towards a previously unsuspected diagnosis. Moreover, in the present case, LE cells were detected in the bone marrow films spread immediately without use of anticoagulants, incubation or any other manipulation which is an exceptional finding reported very rarely in the literature.

Keywords

• SLE
• Bone marrow aspiration
• LE cell