IgA nephropathy in systemic lupus erythematosus patients: case report and literature review

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• 作者：Leonardo Sales da Silva ; Bruna Laiza Fontes Almeida ; Ana Karla Guedes de Melo ; Danielle Christine Soares Egypto de Brito ; Alessandra Sousa Braz ; Eut&iacute ; lia Andrade Medeiros Freire ; ^{eutiliafreire@hotmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Systemic lupus erythematosus ; IgA nephropathy ; Glomerulonephritis
• 刊名：Revista Brasileira de Reumatologia (English Edition)
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：56
• 期：3
• 页码：270-273
• 全文大小：665 K

文摘

Systemic erythematosus lupus (SLE) is a multisystemic autoimmune disease which has nephritis as one of the most striking manifestations. Although it can coexist with other autoimmune diseases, and determine the predisposition to various infectious complications, SLE is rarely described in association with non-lupus nephropathies etiologies. We report the rare association of SLE and primary IgA nephropathy (IgAN), the most frequent primary glomerulopathy in the world population. The patient was diagnosed with SLE due to the occurrence of malar rash, alopecia, pleural effusion, proteinuria, ANA 1: 1280, nuclear fine speckled pattern, and anticardiolipin IgM and 280 U/mL. Renal biopsy revealed mesangial hypercellularity with isolated IgA deposits, consistent with primary IgAN. It was treated with antimalarial drug, prednisone and inhibitor of angiotensin converting enzyme, showing good progress. Since they are relatively common diseases, the coexistence of SLE and IgAN may in fact be an uncommon finding for unknown reasons or an underdiagnosed condition. This report focus on the importance of the distinction between the activity of renal disease in SLE and non-SLE nephropathy, especially IgAN, a definition that has important implications on renal prognosis and therapeutic regimens to be adopted in both the short and long terms.