Systemic lupus erythematosus presenting as lupus erythematosus tumidus and lupus nephritis: a case report

Journal of Medical Case Reports

Case Report

Noureddine Litaiem¹  Ezzeddine Abderrahim²  Imen Gorsane³  Meriam Hajji³  Samaraa Badrouchi³  Soumaya Rammeh⁴  Fethi Ben Hamida⁵ 

[1] Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia;Faculty of Medicine of Tunis, El Manar University, Tunis, Tunisia;Department of Medicine A, Charles Nicolle Hospital, Tunis, Tunisia;Faculty of Medicine of Tunis, El Manar University, Tunis, Tunisia;Department of Medicine A, Charles Nicolle Hospital, Tunis, Tunisia;Kidney Pathology Laboratory LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia;Faculty of Medicine of Tunis, El Manar University, Tunis, Tunisia;Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia;Faculty of Medicine of Tunis, El Manar University, Tunis, Tunisia;Kidney Pathology Laboratory LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia;

关键词: Lupus erythematosus tumidus;    Lupus nephritis;    Glomerulonephritis;    Tumid lupus;    SLE;    Systemic lupus;   

DOI  :  10.1186/s13256-023-03981-3

 received in 2023-03-06, accepted in 2023-05-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLupus nephritis and lupus erythematosus tumidus (LET) are uncommon manifestations of systemic lupus erythematosus (SLE), and their coexistence as the initial presentation of SLE is exceedingly rare. Here, we report such a case, emphasizing the diagnostic challenges and therapeutic implications of this unusual association.Case reportA 38-year-old North African woman presented in Nephrology department with a history of lower extremity edema, fatigue, and weight loss of 3 kg in 4 weeks. Physical examination revealed LET lesions on the chest and the Neck. Laboratory investigations showed lymphopenia, low C3 and C4 complement levels, positive antinuclear antibodies, anti-dsDNA antibodies, and anti-SSA/Ro antibodies. Renal function tests showed normal serum creatinine and nephrotic proteinuria. Renal biopsy revealed Class V lupus nephritis. Skin biopsy confirmed the diagnosis of LET, with the presence of lymphohistiocytic infiltrates and dermal mucin. The patient was diagnosed with SLE based on the 2019 EULAR/ACR criteria and treated with prednisone (1 mg/kg/day) and hydroxychloroquine. She showed significant improvement in her cutaneous and renal symptoms at 6 and 12 months follow-up.ConclusionThe rarity of the coexistence of LET and lupus nephritis as the initial manifestation of SLE, especially in the North African population, underscores the need for further research to elucidate the immunopathogenic mechanisms and prognostic factors associated with this association.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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