It's Not Always Lupus

A 26-year-old female presented with fever on and off since last 5 months with weight loss and loss of appetite. Patient has history of infertility with one spontaneous abortion. Detailed history revealed history of recurrent aphthous ulcers, alopecia, low back ache and arthralgia. On examination patient appeared pale with rashes over her body. Patient had tachycardia with a systolic murmur. Cervical lymph nodes were palpable. Further workup showed persistent bicytopenia, hypertriglyceridemia and hepatosplenomegaly. A detailed evaluation with the help of the team from Rheumatology and Haematology, we concluded the final take on this rare presentation.