title: Successful treatment using cyclosporine in a patient with rhupus complicated by aplastic anemia: a case report and review of the literature.
abstract: Systemic lupus erythematosus (SLE) co-morbid with rheumatoid arthritis (RA) is known as 'Rhupus syndrome' and is estimated to be present in between 0.01 and 2% of SLE and RA patients. The occurrence of aplastic anaemia in a patient with rhupus is very rare and a treatment for this condition has not been reported. A 52-year-old woman presented complaining of nausea and dizziness during the preceding month. She had been treated for rheumatoid arthritis for 16 years. At the time of presentation, she had a malar rash, multiple arthritis, pancytopenia, pleural effusion, proteinuria, and positive anti-nuclear and anti-dsDNA antibodies. A kidney biopsy revealed ISN/RPS class IV-G (A) lupus nephritis. Bone marrow aspiration and biopsy showed aplastic anaemia with no evidence of viral infection. The patient was successfully treated using cyclosporine and prednisolone and she remained symptom-free at the one-and-a-half-year follow-up. To our knowledge, this is the first report of a successful treatment using cyclosporine in a patient with rhupus complicated by aplastic anaemia.
authors.affiliation: Department of Rheumatology, Chonnam National University Medical School, Gwangju, South Korea.
authors.forename: S-R
authors.initials: SR
authors.lastname: Seo
authors.forename: S-J
authors.initials: SJ
authors.lastname: Lee
authors.forename: D-J
authors.initials: DJ
authors.lastname: Park
authors.forename: T-J
authors.initials: TJ
authors.lastname: Kim
authors.forename: Y-W
authors.initials: YW
authors.lastname: Park
authors.forename: S-S
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000741:Anemia, Aplastic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D001706:Biopsy; D001856:Bone Marrow Examination; D015897:Comorbidity; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone