LAUSR

Lupus erythematosus (LE) cell is most commonly a macrophage or neutrophil that contains in its cytoplasm a hematoxylin or LE body. Such body is formed by altered nuclear material derived from the patient leukocytes. Hematoxylin bodies have a round morphology, homogeneous aspect and well-defined limits. They can also be found extracellularly. LE cells in pleural fluid are considered very specific of systemic LE, but have been rarely reported in other autoimmune disorders and drug-induced lupus-like syndrome. In this report we illustrate numerous LE eosinophil cells in a pleural effusion of a patient with probable drug-induced lupus. Eosinophils are rarely mentioned as potential LE cells and we have found no illustrations in the medical literature. The patient, a 74-year-old woman was admitted to the hospital because of dyspnea and a left pleural effusion. She complained of a 6-month history of finger swelling and rigidity in both hands. She suffered from trigeminal neuralgia and was receiving treatment with carbamazepine (CBZ). The articular symptomatology did not precede CBZ administration and appeared while she was already on treatment. Upon admission, the most relevant analytical findings were slight anemia, leukocytes 3.5 × 1000/μL with 7% of eosinophils, elevated C reactive protein (5.59 mg/dL), positive anti-double stranded DNA antibodies, and severe vitamin D deficiency. A complete autoimmune analytical study gave negative results. The effusion fluid was submitted for cytologic and biochemical analysis. Diff-Quik and Papanicolaou stained smears were cellular and revealed numerous neutrophils, eosinophils, macrophages and lymphocytes. Numerous LE cells engulfing characteristic hematoxylin bodies were present. The latter were also present as isolated forms. LE cells were macrophages and neutrophils but the most remarkable LE cells were eosinophils (Figure 1). The blue color of hematoxylin bodies contrasted with the