Table 5 Comparison of the main clinical and pathological features of the two cases (DIC = disseminated intravascular coagulation; SLE = systemic lupus erythematosus)
| Â | Case 1 | Case 2 |
|---|---|---|
Age and Gender | 57Â year old female. | 55Â year old female. |
Past Medical History | Mixed connective tissue disease - including arthritis, Raynaud’s phenomenon and rheumatoid nodules/granuloma annulare. Psoriasis. Multiple drug allergies. | SLE/ Sjogren’s syndrome. Small fibre neuropathy. Asthma. |
Clinical presentation | No sun exposure. Pyrexia (38-40°C), flank pain, urinary frequency, erythematous rash on trunk. Deteriorated into sepsis-like clinical picture. | Sun exposure. Pyrexia (40°C), non-blanching rash over upper arms and thighs, sepsis-like clinical picture. |
Autoantibodies | ANA with speckled pattern, anti-La and RNP. | Anti-Ro and Anti-La. |
Thrombocytopenia/DIC | Yes | Yes |
Acidosis | Yes | Yes |
Lymph node histology | Necrotising lymphadenitis. | Necrotising lymphadenitis. |
Blood vessel thrombosis | No | Yes |
Spleen involvement | Yes | No |