Antinuclear antibody-negative systemic lupus erythematosus (SLE) and severe renal involvement: close correlation between disease activity and appearance of circulating anticoagulant.
A 16-year-old girl meeting the criteria for SLE is described. Salient features of the clinical course included active glomerulonephritis with dense subepithelial deposits on electron microscopy, pulmonary embolism, axillary vein thrombosis, arthritis, serositis and fever. Disease activity correlated with the presence of lupus anticoagulant as measured by VDRL and partial thromboplastin time (PTT). Her serum was consistently negative to ANA, anti-DS-DNA, anti-SS-DNA, ENA, anti-Ro, anti-La, and LE cells for the entire 4-year course. She responded remarkably to prednisone and azathioprine. Reappearance of VDRL and elevated PTT preceded exacerbation of disease activity and served as a serological guide for modifying medical treatment.
D000293:Adolescent; D000974:Antibodies, Antinuclear / Q000032:analysis; D001323:Autoantibodies / Q000276:immunology; D001778:Blood Coagulation Disorders / Q000276:immunology; D001779:Blood Coagulation Factors / Q000276:immunology*; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology; D006801:Humans; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications* / Q000276:immunology; D010314:Partial Thromboplastin Time
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D001779:Blood Coagulation Factors; D016682:Lupus Coagulation Inhibitor