title: New-onset lupus nephritis in a kidney transplant recipient with cystinosis-differential diagnosis with cysteamine-induced lupus: case report.
abstract: A case of lupus nephritis in an adult female kidney transplant recipient with cystinosis under cysteamine therapy is reported. Previous reports of new-onset lupus in cystinotic patients have focused in a possible relationship of lupus with cysteamine therapy, but no obvious pathophysiological association has been disclosed. The authors present a case of a 19-year-old female kidney transplant recipient with cystinosis admitted for acute allograft dysfunction, with clinical and immunologic manifestations of lupus nephritis. Cysteamine was considered as a potential cause of drug-induced lupus, and we temporarily interrupted this drug. The clinical picture, the negativity of antihistone antibodies, the nondisappearance of antinuclear antibodies after discontinuation of the drug, and the clinical stability after resuming cysteamine therapy suggested that the underlying mechanism of lupus was unrelated to the drug. This may be the first report of new-onset lupus in a kidney transplant recipient with cystinosis. Clinicians should be aware of the association of autoimmune abnormalities in patients with cystinosis.
authors.affiliation: Department of Nephrology and Transplantation, Hospital Santo António, Porto, Portugal. sofiarocha81@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Rocha
authors.forename: L S
authors.initials: LS
authors.lastname: Martins
authors.forename: R
authors.initials: R
authors.lastname: Vizcaíno
authors.forename: L
authors.initials: L
authors.lastname: Dias
authors.forename: M
authors.initials: M
authors.lastname: Almeida
authors.forename: S
authors.initials: S
authors.lastname: Pedroso
authors.forename: J
authors.initials: J
authors.lastname: Vidinha
authors.forename: M
authors.initials: M
authors.lastname: Rocha
authors.forename: G
authors.initials: G
authors.lastname: Rocha
authors.forename: C
authors.initials: C
authors.lastname: Mota
authors.forename: A
authors.initials: A
authors.lastname: Henriques
authors.forename: A
authors.initials: A
authors.lastname: Cabrita
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003543:Cysteamine / Q000009:adverse effects*; D003554:Cystinosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D011237:Predictive Value of Tests
chemical_list: D000974:Antibodies, Antinuclear; D015415:Biomarkers; D007166:Immunosuppressive Agents; D003543:Cysteamine