IgA nephropathy in systemic lupus erythematosus patients: case report and literature review.
Systemic erythematosus lupus (SLE) is a multisystemic autoimmune disease which has nephritis as one of the most striking manifestations. Although it can coexist with other autoimmune diseases, and determine the predisposition to various infectious complications, SLE is rarely described in association with non-lupus nephropathies etiologies. We report the rare association of SLE and primary IgA nephropathy (IgAN), the most frequent primary glomerulopathy in the world population. The patient was diagnosed with SLE due to the occurrence of malar rash, alopecia, pleural effusion, proteinuria, ANA 1: 1280, nuclear fine speckled pattern, and anticardiolipin IgM and 280U/mL. Renal biopsy revealed mesangial hypercellularity with isolated IgA deposits, consistent with primary IgAN. It was treated with antimalarial drug, prednisone and inhibitor of angiotensin converting enzyme, showing good progress. Since they are relatively common diseases, the coexistence of SLE and IgAN may in fact be an uncommon finding for unknown reasons or an underdiagnosed condition. This report focus on the importance of the distinction between the activity of renal disease in SLE and non-SLE nephropathy, especially IgAN, a definition that has important implications on renal prognosis and therapeutic regimens to be adopted in both the short and long terms.
School of Medicine, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
Leonardo Sales
LS
da Silva
School of Medicine, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
Bruna Laiza Fontes
BL
Almeida
School of Medicine, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
Ana Karla Guedes
AK
de Melo
School of Medicine, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
Danielle Christine Soares Egypto
DC
de Brito
School of Medicine, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
Alessandra Sousa
AS
Braz
School of Medicine, Universidade Federal da Paraíba, João Pessoa, PB, Brazil. Electronic address: eutiliafreire@hotmail.com.
Eutília Andrade Medeiros
EA
Freire
D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D009393:Nephritis; D011507:Proteinuria
Glomerulonefrite; Glomerulonephritis; IgA nephropathy; Lúpus eritematoso sistêmico; Nefropatia por IgA; Systemic lupus erythematosus