Objectives Lymphadenopathy is a classical manifestation of systemic lupus erythematosus (SLE) flare, occurring in approximately half of patients during the course of the disease. Lymphadenopathy in SLE is frequently associated with fever. Microbial infection may play a role in SLE onset and flares. Objectives of this study were to describe lymphadenopathy in the course of SLE and identify potential infectious triggers using microbial metagenomic analysis. Methods We performed a retrospective monocentric study of 38 patients with SLE who had lymph node biopsy at baseline or during follow-up. Shotgun metagenomics were performed in patient’s lymph node biopsy to look for microbial RNA and/or DNA. Results Lymph node pathological analyses revealed follicular and/or paracortical hyperplasia 73.7% of patients and histiocytic necrotizing lymphadenitis 23.7%. At the time of biopsy, SLE patients exhibited fever in 29%, splenomegaly in 10%, cutaneous manifestations in 47%, polyarthritis in 32%, seritis in 13% and lupus nephritis in 18%. Half of patients (50%) had increased CRP level, 35% had low C3, 65% had hypergammaglobulinemia. Microbial metagenomic analysis of lymph node biopsy did not reveal the presence of microbial DNA in 92% of patients, the presence of CMV in very small quantities in 2 patients, and the presence of HHV-7 in low quantities in a single patient. Conclusion Despite suggestion that certain microorganisms may play a role in the pathogenesis and flares of SLE, our microbial metagenomic analysis study did not highlight possible infectious triggering factors. Further and better-designed studies are needed to confirm these results.

中文翻译：

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系统性红斑狼疮的淋巴结肿大：在一项针对 38 例患者的回顾性研究中，鸟枪法宏基因组学未发现微生物触发因素


目的淋巴结肿大是系统性红斑狼疮 （SLE） 发作的典型表现，在病程中约有一半的患者发生。SLE 患者的淋巴结肿大通常与发热有关。微生物感染可能在 SLE 发作和发作中起作用。本研究的目的是描述 SLE 过程中的淋巴结肿大，并使用微生物宏基因组分析确定潜在的感染触发因素。方法 我们对 38 例在基线或随访期间进行淋巴结活检的 SLE 患者进行了回顾性单中心研究。在患者的淋巴结活检中进行鸟枪法宏基因组学检查，以寻找微生物 RNA 和/或 DNA。结果 淋巴结病理分析显示 73.7% 的患者为滤泡性和/或皮质旁增生，23.7% 的患者为组织细胞坏死性淋巴结炎。活检时，SLE 患者表现为发热 29%，脾肿大 10%，皮肤表现 47%，多关节炎 32%，丝氨酸炎 13%，狼疮性肾炎 18%。一半患者 （50%） CRP 水平升高，35% C3 低，65% 高丙种球蛋白血症。淋巴结活检的微生物宏基因组分析未显示 92% 的患者存在微生物 DNA，2 例患者存在极少量的 CMV，1 例患者存在少量的 HHV-7。结论 尽管有研究表明某些微生物可能在 SLE 的发病机制和发作中发挥作用，但我们的微生物宏基因组分析研究并未强调可能的感染触发因素。需要进一步和设计更好的研究来证实这些结果。