Visceral leishmaniasis masquerading as autoimmune disease flare in a non-endemic area: diagnostic challenges and the role of targeted next-generation sequencing.
Yuke Tian, Linjie Zhong, Xin Zhao
✦ AI-curated · Sources linked
Case in brief
A 57-year-old woman with a history of systemic lupus erythematosus and Sjögren syndrome presented with anorexia, vomiting, intermittent fever, and splenomegaly. Initial tests revealed marked hypergammaglobulinaemia and progressive pancytopenia. Targeted next-generation sequencing identified Leishmania donovani, leading to a diagnosis of visceral leishmaniasis. After treatment with sodium stibogluconate, her symptoms resolved, blood counts improved, and skin hyperpigmentation diminished.
Diagnostic / clinical pearl
In immunosuppressed patients from non-endemic areas, visceral leishmaniasis should be considered when presenting symptoms overlap with autoimmune disease flares, especially in the absence of travel history to endemic regions.
Why it matters
This case highlights the utility of targeted next-generation sequencing in diagnosing infections that may mimic autoimmune conditions, facilitating timely and appropriate treatment.