PDF
ePub
Citation
Print
Abstract
Renal involvement in systemic lupus erythematosus (SLE) is a typical manifestation of the disease. The occurrence of non-lupus nephritis, especially IgA nephropathy (IgAN), in patients with SLE has rarely been reported. We describe the case of a 21-year-old woman who was diagnosed with IgAN and subacute necrotizing lymphadenitis, and her renal lesion biopsy was typical of lupus nephritis (ISN/RPS Class III). Although IgAN and lupus nephritis share some common physiopathological characteristics, their laboratory, histopathologic findings, and the extra-renal clinical manifestations are different and support a different pathogenesis. Our case highlights the importance of a renal biopsy in patients with lupus and urinary alterations despite underlying IgAN. A correct diagnosis would permit the most appropriate immunosuppressive treatments to be considered.
REFERENCES
1). Huong DL., Papo T., Beaufils H., Wechsler B., Bletry O., Baumelou A, et al. Renal involvement in systemic lupus erythematosus. A sduty of 180 patients from a single center. Medicine (Baltimore). 1999. 78:148–66.
2). Sada KE., Makino H. Usefulness of ISN/RPS classification of lupus nephritis. J Korean Med Sci. 2009. ;24 (Suppl 1): S7-10.
3). Gunnarsson I., Ronnelid J., Lundberg I., Jacobson SH. Occurrence of anti-C1q antibodies in IgA nephropathy. Nephrol Dial Transplant. 1997. 12:2263–8.
4). Gladman DD. Prognosis and treatment of systemic lupus erythematosus. Curr Opin Rheumatol. 1996. 8:430–7.
5). Baranowska-Daca E., Choi YJ., Barrios R., Nassar G., Suki WN., Truong LD. Nonlupus nephritis in patients with systemic lupus erythematosus: a comprehensive clinicopathologic study and review of the literature. Hum Pathol. 2001. 32:1125–35.
6). Bang SY., Kim GH., Shin DH., Park MH., Jun JB. A case of IgA nephropathy associated with systemic lupus erythematosus. J Korean Rheum Assoc. 2009. 16:54–8.
7). Horino T., Takao T., Terada Y. IgA nephropathy in a patient with systemic lupus erythematosus. Lupus. 2010. 19:650–4.
8). Basile C., Semeraro A., Montanaro A., Giordano R., Padova F., Marangi AL, et al. IgA nephropatphy in a patient with systemic lupus erythematosus. Nephrol Dial Transplant. 1998. 13:1891–2.
9). Han KW., Lee YK., Lee HR., Hwang SI., Kim SG., Oh JE, et al. A case of IgA neprhopathy with systemic lupus nephritis. Korean J Nephrol. 2005. 24:326–31.
10). Galla JH. IgA nephropathy. Kidney Int. 1995. 47:377–87.
11). Donadio JV., Grande JP. IgA nephropathy. N Engl J Med. 2002. 347:738–48.
12). De Siati L., Paroli M., Ferri C., Muda AO., Bruno G., Barnaba V. Immunoglobulin A nephropathy complicating pulmonary tuberculosis. Ann Diagn Pathol. 1999. 3:300–3.
13). Eisner MD., Amory J., Mullaney B., Tierney L Jr., Browner WS. Necrotizing lymphadenitis associated with systemic lupus erythematosus. Semin Arthritis Rheum. 1996. 26:477–82.
14). Topaloglu R., Bakkaloglu A., Slingsby JH., Mihatsch MJ., Pascual M., Norsworthy P, et al. Molecular basis of hereditary C1q deficiency associated with SLE and IgA nephropathy in a Turkish family. Kidney Int. 1996. 50:635–42.
15). Menegatti E., Nardacchione A., Alpa M., Agnes C., Rossi D., Chiara M, et al. Polymorphism of the Uteroglobin gene in systemic lupus erythematosus and IgA nephropathy. Lab Invest. 2002. 82:543–6.
XML Download