Severe lupus after two years of hemodialysis: It exists and can be serious.

Autor: Jabrane M; Department of Nephrology and Kidney Transplantation, Hassan II Hospital, Faculty of Medicine and Pharmacy, Medical University Hospital, Ibn Zohr University, Agadir, Morocco., Bouchoual M; Department of Nephrology and Kidney Transplantation, Hassan II Hospital, Faculty of Medicine and Pharmacy, Medical University Hospital, Ibn Zohr University, Agadir, Morocco., Arrayhani M; Department of Nephrology and Kidney Transplantation, Hassan II Hospital, Faculty of Medicine and Pharmacy, Medical University Hospital, Ibn Zohr University, Agadir, Morocco.
Jazyk: angličtina
Zdroj: The Egyptian journal of internal medicine [Egypt J Intern Med] 2023; Vol. 35 (1), pp. 24. Date of Electronic Publication: 2023 Mar 30.
DOI: 10.1186/s43162-023-00208-1
Abstrakt: Progression of lupus nephropathy (LN) to end-stage renal disease is a serious complication and requires subsequent replacement therapy. Lupus disease activity is extinguished in chronic hemodialysis. We report the observation of a 35-year-old female patient, in conventionnel hemodialysis for two years (chronic glomerulonephritis), admitted to the emergency room for convulsions, left flaccid tenderness, cutaneous-mucosal pallor and altered general condition evolving since three days before her admission. we also observed a spontaneous ecchymotic lesions on the right arm. Echodoppler of the right upper extremity was in favor of a partially thrombosed aneurysm of the right brachial artery. The biological workup showed pancytopenia, the requested immunological workup showed a low complement C 3 , a positive level of anti-DNA antibodies. The patient was treated as severe lupus flare: Bolus of methylprednisolone, followed by oral administration, associated with Mycophenolate mofétil (MMF) at a dose of 1 g/d. The evolution was favorable on the clinical, biological and radiological levels. Systemic lupus erythematous (SLE) can occur even after several years of hemodialysis and sometimes in a severe form, pushing the clinician to think of this pathology in the presence of evocative signs.
Competing Interests: Competing interestsNone declared.
(© The Author(s) 2023.)
Databáze: MEDLINE
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