Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect almost any organ in the body. It usually runs a chronic course with systemic inflammation, and age at diagnosis varies from 15 to 44 years. Laboratory reports often show high anti-nuclear antibody (ANA) levels, increased anti-double-stranded deoxyribonucleic acid (anti-dsDNA) levels, and low complement levels. 'Lupus flare' is a term used for an acute exacerbation of previously existing SLE. It usually manifests as an acute worsening of clinical signs and symptoms, along with an abrupt change in typical laboratory values. Triggers for a lupus flare include viral or bacterial infections, acute stress, and various environmental factors such as ultraviolet (UV) light. Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic used for various bacterial infections. On rare occasions, ciprofloxacin can cause adverse effects in the body, which may resemble an acute flare of SLE symptoms in patients with previously controlled disease. We have presented such a case of ciprofloxacin-induced reactions mimicking a lupus flare in an SLE patient.
Highlights
Systemic lupus erythematosus (SLE) is a chronic multi-systemic disease of autoimmune origin
Lupus flares can occur during the disease course, and the management strategy should revolve around avoiding risk factors along with early diagnosis and treatment [3]
We initially considered urinary tract infection (UTI) as the cause of lupus flare symptoms in our patient, as acute infections are a known cause of SLE exacerbations, but the timing of onset of this infection and antibiotic use disproved our notion
Summary
Systemic lupus erythematosus (SLE) is a chronic multi-systemic disease of autoimmune origin. Our case is that of a 34-year-old Southeast Asian female with a two-year history of SLE, which initially manifested with arthralgias, malar rash, anemia, and proteinuria, and she was diagnosed with positive antinuclear antibodies, low complement levels, and increased anti-ds DNA levels. She had good control over her disease with low-dose prednisolone and hydroxychloroquine. During her two-year disease course, she suffered from upper respiratory tract infections and urinary infections multiple times, along with intermittent arthralgias During this visit, she presented in the outdoor patient department with a complaint of low-grade fever and burning micturition for the previous two days. After resolution of the acute symptoms, we discharged her on cefixime and referred her to a rheumatologist for lupus follow-up
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