Systemic lupus erythematosus presenting with features suggestive of human immunodeficiency virus infection

We describe 8 patients who presented with fever, weight loss, anemia, and oral and/or esophageal candidiasis, and who were initially thought to have human immunodeficiency virus (HIV) infection or lymphoma. These patients fulfilled American College of Rheumatology criteria for systemic lupus erythematosus (SLE) because of arthralgias or arthritis, hematological derangements, and immunological abnormalities. Treatment was delayed because SLE did not immediately enter into the differential diagnosis. All patients had a rapid response to corticosteroids, with defervescence of fever, decrease in lymphadenopathy within 24-48 hours, and complete resolution of lymphadenopathy and other signs and symptoms of illness in 7-10 days. It is important to recognize this mode of SLE presentation in patients who test negative for HIV infection so that the appropriate diagnostic evaluation and initiation of treatment can be expedited.