Hepatomegaly , Splenomegaly and lymphadenopathy in Iraqi patients with Systemic Lupus Erythematosus


  • Naser Husain Sabr M . B . CH . B D . R . M . R
  • Khalaf Anber Obaid M . B . CH . B D . R . M . R
  • Adnan Hiyal Nisan M. B . CH . B D . R . M . R


Systemic lupus erythematosus, Lymphadenopathy


Background:      Systemic lupus erythematosus (SLE) is an autoimmune disease which is known to present with a wide variety of clinical manifestations. Liver and spleen enlargement in SLE are common finding but their prevalence and association with lymph node involvement not fully studied in Iraqi patients. Aim of study: Assessment of hepatomegaly and splenomegaly and their relation with lymphadenopathy in Iraqi patients having systemic lupus erythematosus. Method: A cross sectional analytical study was done on 50 systemic lupus erythematosus Iraqi patients with active disease according to SLE disease activity index. The patients were attending rheumatology and rehabilitation unit in Al-Hussein teaching hospital. Results: In our study we found that hepatomegaly was seen in 36% of patients, splenomegaly in 28% while lymphadenopathy in 26%. We noticed that hepatomegaly and splenomegaly were higher in those having lymphadenopathy compared to those without lymph node involvement. Also liver, spleen and lymph node involvement associated with more mucocutaneuos and constitutional manifestation, while no differences were noticed in renal and neuropsychiatric manifestation .


Mary K. Crow. Etiology and Pathogenesis of Systemic Lupus Erythematosus in : GARY S. FIRESTEIN , RALPH C.BUDD, SHERINE GABRIEL IAIN B. McINNES ,JAMES R. O,DELL ed KELLY & FIRESTEIN,S Textbook of Rheumatology Tenth edition EL SEVIER 2017 ;1329 – 1344 .

Vijay Rao , Rosalind Ramsey – Goldman , Caroline Gordan Systemic Lupus Erythematosus and Lupus- Like Syndromes in Ade Adebajo, Lisa Dunkley eds : ABC of Rheumatology Fifth edition 2018 WILEY Blackwell. BMJI Books 119-127.

S.H.Ralston , I. B. Mclnnes. Rheumatology and bone disease. In:Brian R. Walker ,Nicki R .Colledge .Stuart H.Ralston ,Ian D .Penman. eds .Davidsons Principles and Practice of Medicine 22nd Edition ELSEVIER ,CHURCHIL LIVINGSTONE , 2014;1057-1135.

Caroline Gordon Systemic lupus erythematosus –clinical features and aetiopathogenesis in :Richard A.Watts , Philip G Conaghan ,Christopher Denton , Helen Foster ,John Isaacs, Ulf Muller –Lander eds Oxford Textbook of Rheumatology Fourth Edition 2013 ;923-937 OXFORD UNIVERSITY PRESS.

JILL P. BUYON Systemic Lupus Erythematosus A.Clinical and Laboratory Features In :John H.Klippel, John H. Stone, Leslie J .Crofford ,Patience H .White eds Primer on The Rheumatic Diseases 13th Edition. Arthritis Foundation ,Springer 2008;303-318.

Al-Rawi Z ,Al-Shaarbaf H, Al- Raheem E,Khalifa S J.Clinical Features of Early Cases of Systemic Lupus Erythematosus in Iraqi patients Br J Rheumatol 1983; 22:165-171.

22. George A.Karpouzas , Dubois' Lupus Erythematosus and Related Syndromes , Hematologic and Lymphoid Abnormalities in SLE , (Ninth Edition).2019, pages 473-485.

J Runde , R K Azzam . Paediatric Annals , 2018 healio.com.

Marria Dall , Era , David Wofsy .Clinical Features of Systemic Lupus Erythematosus in :


23.Gladman DD, Urowitz MB .Systemic Lupus Erythematosus. Clinical Features , In :Schumacher HR ,Klippel JH , Koopman WJ eds Primer on the Rheumatic Diseases 10th ed. Arthritis Foundation , Atalanta ,Georgia ,1993;106-111.

Hall FC ,Walport MJ ,Systemic Lupus Erythematosus . Medicine International 1994 ;22: 285-294

Childs JC ,Adelizzi RA ,Dabro MB ,Freed N. Splenic hypofunction in systemic lupus erythematosus. J Am Osteopath Assoc1994 ;94:414-41

Valles R , Rivero I, Moran D, Diumenjo MS. Spontaneous splenic hypofunction in systemic lupus erythematosus and primery Sjogrens syndrome.Medicina B Aires 1993;53:397-400.

A J Cruz ,A Castro –Case Reports,2015- casereports.bmj.com.

Shapira Y ,Weinberger A ,Wysebbeek AJ, Lymphadenopathy in systemic lupus erythematosus .Prevalence and relation to disease manifestations. Clin Rheumatol 1996;15:335-338.

M ÇALGÜNERI, MA ÖZTÜRK, Z ÖZBALKAN, A AKDOGAN, K ÜRETEN, S KIRAz AND I ERTENLI. Frequency of Lymphadenopathy in Rheumatoid Arthritis and Systemic Lupus Erythematosus , The Journal of International Medical Research 2003; 31: 345 – 349.

Bhalla R, Ajmani HS, Kim WW, Swedler WI, Lazarevic MB ,Skosey JL, Systemic lupus erythematosus and Hodgkins lymphoma. J Rheumatol,1993;20:1316-1320.

Rothfield NF .Systemic Lupus Erythematosus :Clinical Aspects and Treatment In : McCARTY DJ ed Arthritis and Allied Conditions.10th ed. Philadelphia : Lea and Febiger,1985;911-935.

.Hoshberg MC : Updating the American College of Rheumatology revised criteria for the classification of Systemic Lupus Erythematosus . Arthritis Rheum 40 : 1725, 1997.

.Dafna D.Gladman , Dominique Ibanez, Murray B. Urowitz. Systemic Lupus Erythematosus disease activity index 2000 (SLEDAI-2K), The Journal of Rheumatology 29 (2),288-291,2002.

.Ibrahim H .Splenomegaly in Adult Iraqi Patients. J Fac Med Baghdad ,1977;19 :67-72.

.Ibrahim A M . Clinical and Immunological Study of SLE 1986 , 143.(M.Sc Thesis).University of Baghdad.