{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T17:51:49Z","timestamp":1767117109662},"reference-count":60,"publisher":"Akademiai Kiado Zrt.","issue":"3","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2019,5,17]]},"abstract":"<jats:p>Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease that can affect major organs possibly leading to life-threatening complications and appears with heterogeneous clinical picture. SLE could present with broad spectrum of clinical and laboratory features that can resemble those of other diseases, such as hemopoietic malignancies, infections, or immune-mediated disorders. Its complexity and protean features overlap with many other diseases, hindering the differential diagnosis. Rarely, true overlap with other diseases may occur. Herein, we report a case series of two patients affected by infectious diseases, namely visceral leishmaniasis and Whipple\u2019s disease (WD), intertwined with clinical or serological features of SLE. In both cases, several confounding factors have led to a delay in the diagnosis. Moreover, we first describe the persistent elevation of autoantibodies and a monoclonal gammopathy in a patient with WD. Awareness of unusual presentations of infections or other rare disorders, which may be encountered in clinical practice when taking care of SLE patients, is essential for timely diagnosis and treatment of potentially lethal diseases.<\/jats:p>","DOI":"10.1556\/030.66.2019.013","type":"journal-article","created":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T08:12:55Z","timestamp":1558080775000},"page":"377-385","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":3,"title":["Clinical pitfalls of leishmaniasis and Whipple\u2019s disease hidden behind systemic lupus erythematosus: A case series"],"prefix":"10.1556","volume":"66","author":[{"given":"Francesca","family":"Losa","sequence":"first","affiliation":[{"name":"1 Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital \u201cDuilio Casula\u201d, University of Cagliari, Monserrato (Cagliari), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Firinu","sequence":"additional","affiliation":[{"name":"1 Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital \u201cDuilio Casula\u201d, University of Cagliari, Monserrato (Cagliari), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margherita","family":"Deidda","sequence":"additional","affiliation":[{"name":"1 Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital \u201cDuilio Casula\u201d, University of Cagliari, Monserrato (Cagliari), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Costanzo","sequence":"additional","affiliation":[{"name":"1 Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital \u201cDuilio Casula\u201d, University of Cagliari, Monserrato (Cagliari), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano R.","family":"del Giacco","sequence":"additional","affiliation":[{"name":"1 Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital \u201cDuilio Casula\u201d, University of Cagliari, Monserrato (Cagliari), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref291","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1097\/PAS.0b013e31825a2fa4","article-title":"Whipple disease a century after the initial description: Increased recognition of unusual presentations, autoimmune comorbidities, and therapy effects","volume":"36","author":"Arnold","year":"2012","journal-title":"Am J Surg Pathol"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1556\/030.65.2018.027","article-title":"Comparison of polymerase chain reaction-restriction enzyme analysis method and DNA sequence analysis results in the identification of non-tuberculous mycobacteria","volume":"65","author":"Appak","year":"2018","journal-title":"Acta Microbiol Immunol Hung"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1191\/096120398678920596","article-title":"Exacerbation of systemic lupus erythematosus related to cytomegalovirus infection","volume":"7","author":"Hayashi","year":"1998","journal-title":"Lupus"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1136\/ard.2007.070367","article-title":"EULAR recommendations for the management of systemic lupus erythematosus. 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