Respiratory failure and macrophage activation syndrome as an onset of systemic lupus erythematosus: A case report

Table 1 Laboratory data and infection work-up

Items	Result	Reference values
Sedimentation (mm/h)	12	0-34
C-reactive protein (mg/L)	5.6	0-10
WBC (× 109/L)	2.41	3.5-9.5
Neutrophils	1.82	1.8-6.3
PLT (× 109/L)	9	125-350
Hb (g/L)	66	115-150
Triglyceride (mmol/L)	4.29	< 1.7
Fibrinogen (mg/dL)	61	200-400
D-dimer (mg/L)	2.43	< 0.55
Total bilirubin (μmol/L)	201.9	3.42-20.5
Direct bilirubin (μmol/L)	155.2	0-6.8
Hepatitis virus DNA	Not detected
HIV, EB-virus and cytomegalovirus	Not detected
IgG and IgM of M. pneumoniae	Negative	Negative
Blood cultures for pathogens	Negative	Negative
T-SPOT and acid-resistant staining	Negative	Negative
Full-set tumor markers	Negative	Negative

PLT: Platelet; Hb: Hemoglobin; HIV: Human immunodeficiency virus.

Table 2 Autoimmune work-up and biopsy results

Items	Result	Reference values
ANA antibody	1:320(+)	Negative
Anti-Ro-52	++	Negative
Anti-SS-A	+++	Negative
Anticardiolipin IgM	+	Negative
Anti-dsDNA	Negative	Negative
Anti-SM	Negative	Negative
Complement C3 (g/L)	0.439	0.79-1.52
Complement C4 (g/L)	0.18	0.16-0.38
ANCA	Negative	Negative
MPO+PR3	Negative	Negative
IgG4 (g/L)	0.164	0.03-2.01
Soluble CD25 (pg/mL)	8516	< 6400
Crushed red blood cells and Coombs test	Negative	Negative
Natural killer cell function	Not able to complete
Lymph node biopsy	Kikuchi lymphadenitis, CD68/CD163 positive by immunohistochemistry analysis	Negative

ANA: Antinuclear antibody; ANCA: Antinuclear cytoplasmic antibody; MPO: Myeloperoxidase; PR3: Protease 3.