{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T15:24:27Z","timestamp":1774538667357,"version":"3.50.1"},"reference-count":29,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,8]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Systemic lupus erythematosus is an autoimmune disease with diverse systemic manifestations, while Castleman disease is a rare lymphoproliferative disorder that often presents with systemic symptoms and can mimic autoimmune disorders. \u03b2-thalassaemia trait is a genetic disorder characterised by mild anaemia. We report the case of a young female who presented with febrile episodes persisting for 6\u2009months, accompanied by multiple joint pain and left-sided chest pain for 3\u2009months. Physical examination revealed pallor, generalised lymphadenopathy, splenomegaly and left-sided pleural effusion. Lymph node biopsy initially suggested Castleman disease\u2014hyaline vascular variant. However, further evaluation led to a final diagnosis of systemic lupus erythematosus with lupus nephritis and concomitant \u03b2-thalassaemia trait. This case highlights the diagnostic challenge when multiple diseases with overlapping symptoms coexist and the importance of a comprehensive evaluation in patients with atypical presentations to avoid diagnostic overshadowing.<\/jats:p>","DOI":"10.1136\/bcr-2024-264605","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T04:10:18Z","timestamp":1747887018000},"page":"e264605","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic pitfall: Castleman\u2019s disease versus systemic lupus erythematosus in a woman with generalised lymphadenopathy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3407-6030","authenticated-orcid":false,"given":"Shalini","family":"Radhakrishnan","sequence":"first","affiliation":[{"name":"Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaithra","family":"Gowthuvalli Venkataramana","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0460-7913","authenticated-orcid":false,"given":"Chakrapani","family":"Mahabala","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohan Bhojraja","family":"Varadanayakanahalli","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 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