An antinuclear antibody-negative patient with lupus nephritis.
Systemic lupus erythematosus (SLE) is a typical autoimmune disease that's characterized by various autoantibodies to nuclear and cytoplasmic antigens. The presence of antinuclear antibodies (ANA) in serum is generally considered a decisive diagnostic sign of SLE. However, a small subset of SLE patients who had the typical clinical features of SLE was reported to show persistently negative ANA tests. Our report describes a 16-yr-old female who presented with the clinical manifestations of SLE such as malar rash, photosensitivity, arthritis, lymphopenia, pericarditis and proteinuria. The serum autoantibodies were all negative and renal biopsy showed that the histopathological changes of immune complex mediated the focal segmental necrotizing glomerulonephritis with crescent formation. She was treated with monthly pulse cyclophosphamide along with corticosteroids. During the 2-yr follow-up period, the proteinuria was markedly decreased and all of the ANA and anti-double stranded DNA antibody tests were negative. This case suggests that ANA may not be required in the pathogenesis of lupus nephritis.
Kim
Hyoun Ah
HA
Department of Allergy & Rheumatology, Ajou University School of Medicine, Suwon, Korea.
Chung
Jae Wook
JW
Park
Han Jung
HJ
Joe
Dai Yeol
DY
Yim
Hyun Ee
HE
Park
Hae Sim
HS
Suh
Chang Hee
CH
D000293:Adolescent; D000974:Antibodies, Antinuclear / Q000276:immunology*; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008181:Lupus Nephritis / Q000175:diagnosis / Q000276:immunology*; D014057:Tomography, X-Ray Computed
D000974:Antibodies, Antinuclear