Unusual presentation of lupus nephritis.
We report a male patient who presented with pyrexia, generalized lymphadenopathy, hepatosplenomegaly, and pleural effusion with no cutaneous or musculoskeletal symptoms. Despite extensive investigation, no cause was detected. His initial serology was also negative for autoantibodies. The patient was placed on a trial of antitubercular treatment in view of a positive Mantoux test. His disease evolved into the full clinical picture of systemic lupus erythematosus with nephritis (World Health Organisation class IV) and strongly positive antinuclear antibody and dsDNA over a period of months. He was treated successfully with intravenous cyclophosphamide pulses along with oral prednisolone, and the disease was still in remission after 3 years of follow-up.
Gupta
R
R
Clinical Immunology and Rheumatology Services, Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, 110029 New Delhi , India. guptarajiva@hotmail.com
Gulati
N
N
Gupta
A
A
Kumar
A
A
Dinda
A K
AK
Sharma
S K
SK
D000328:Adult; D000974:Antibodies, Antinuclear / Q000276:immunology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008181:Lupus Nephritis / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology*; D008297:Male; D012074:Remission Induction
D000974:Antibodies, Antinuclear; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide