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The following is a summary of “Lymphadenopathy in systemic lupus erythematosus: no microbial trigger found by shotgun metagenomics in a retrospective study on 38 patients,” published in the October 2024 issue of Rheumatology by Papo et al. 

Lymphadenopathy, a classic manifestation of systemic lupus erythematosus (SLE), occurs in about half of patients and is often associated with fever, with microbial infection potentially influencing SLE onset and flares. 

Researchers conducted a retrospective study to describe lymphadenopathy in SLE and identify potential infectious triggers using microbial metagenomic analysis. 

They conducted a retrospective study of 38 patients with SLE who had lymph node biopsies at baseline or follow-up, using shotgun metagenomics to detect microbial RNA and/or DNA. 

The results showed lymph node pathological analyses revealed follicular and/or paracortical hyperplasia in 73.7% of patients and histiocytic necrotizing lymphadenitis in 23.7%. At biopsy, patients with SLE exhibited fever in 29%, splenomegaly in 10%, cutaneous manifestations in 47%, polyarthritis in 32%, seritis in 13%, and lupus nephritis in 18%. Half of the patients (50%) had increased CRP levels, 35% had low C3, and 65% had hypergammaglobulinemia. Microbial metagenomic analysis found no microbial DNA in 92% of patients, with CMV detected in 2 patients and HHV-7 in 1 patient. 

The study concluded that while some microorganisms may influence SLE flares, the microbial metagenomic analysis found no infectious triggers, highlighting the need for further research. 

Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae578/7848462