Jurnal Kedokteran dan Kesehatan Indonesia Indonesian Journal of Medicine and Health Journal homepage : www.journal.uii.ac.id/index.php/JKKI ABSTRACT ARTICLE INFO Recurrent Mycobacterium tuberculosis infection in systemic lupus erythematosus patient: case report and review Anthony Paulo Sunjaya* 1 , Devi Astri Rivera Amelia 2 1 Faculty of Medicine, Tarumanagara University, Jakarta, Indonesia 2 Department of Internal Medicine, Ciawi General Hospital, West Java, Indonesia *Corresponding author: anthony@doctors.web.id Keywords: systemic lupus erythematosus, recurrent tuberculosis, autoimmune haemolytic ane- mia History: Received: August 1, 2018 Accepted: April 2, 2019 Online: April 30, 2019 DOI : 10.20885/JKKI.Vol10.Iss1.art14 Case Report Copyright @2019 Authors. This is an open access article distributed under the terms of the Creative Commons At- tribution-NonCommercial 4.0 International Licence (http:// creativecommons.org/licences/ by-nc/4.0/). 97 Systemic Lupus Erythematosus (SLE) is an autoimmune disorder characterised by an underlying immunodeficiency state, worsened by the use of immunosuppressive drugs in its treatment. Hence patients with SLE are at increased risk of opportunistic infections, one of which is tuberculosis. Tuberculosis (TB) is one of the most common infectious diseases globally, with Indonesia having the second highest prevalence in the world. Further research towards better management of these two disease entities is thus required. We report a patient with SLE flare and recurrent tuberculosis infection. Lupus eritematosus sistemik (SLE) merupakan kelainan autoimun yang ditandai dengan kondisi imunodefisiensi, yang diperburuk kondisinya selama pengobatan dengan penggunaan obat imunosupresif. Pasien dengan SLE memiliki risiko infeksi oportunistik, salah satunya adalah tuberkulosis. Tuberkulosis (TB) adalah salah satu penyakit menular yang paling umum di dunia. Indonesia memiliki prevalensi tertinggi kedua di dunia. Oleh karena itu diperlukan penelitian lebih lanjut mengenai manajemen yang lebih baik dari penyakit ini. Kami melaporkan seorang pasien dengan ruam SLE dan infeksi tuberkulosis berulang. INTRODUCTION Systemic Lupus Erythematosus (SLE) is an autoimmune disorder characterised by an underlying immunodeficiency state worsened by the use of immunosuppressive drugs in its treatment. Hence patients with SLE are at increased risk of opportunistic infections, one of which is tuberculosis. Tuberculosis (TB) is one of the most common infectious diseases globally, with Indonesia having the second highest prevalence in the world today. A previous study in Spain has reported a six fold increase in TB incidence in the SLE group compared to the general population. In Hongkong, a similar study has reported an increased risk of up to 15 fold in SLE patients. We report a case of SLE flare with recurrent tuberculosis infection and autoimmune haemolytic anaemia. Informed consent was obtained from the patient for this report. 1-5 CASE PRESENTATION A 42-year old female presented to the outpatient department with a one-week history of haemoptysis and discoid skin rash as well as swollen joints over the lower extremities which appeared after her daily methylprednisolone dose was tapered down a week ago. The patient also complained lethargy, night sweats, weight loss (3 kg over two weeks), loss of appetite,