Hepatic Haemangioma Mimicking an Abscess in a Young Female: An Atypical Presentation of SLE

This case describes a 33-year-old woman who presented with progressive weight loss, fever and fatigue, and was initially treated as a pyrexia of unknown origin. Computed tomography (CT) findings contributed to diagnostic momentum and suggested a hepatic abscess. Initial blood tests showed anaemia and leukopenia. Human immunodeficiency virus (HIV), hepatitis, <i>Treponema</i> and malaria screens were negative. Various antibiotics were trialled with no significant improvement in the clinical picture. A magnetic resonance imaging (MRI) of the liver excluded a hepatic abscess and instead confirmed a hepatic haemangioma. An autoimmune screen showed serology that was overall associated with systemic lupus erythematosus (SLE). The patient was promptly commenced on steroids and clinically improved. In this case report, we review the current literature around SLE and its association with hepatic haemangiomas. Key messages from this case include considering early autoimmune screens for atypical presentations and correlating radiological features with clinical findings.