Case report of a lupus patient with a severe flare and miliary tuberculosis: need for proper guidelines for management
| Autor: | Ata Ur Rehman, Ramsa Suhail Rana, Muhammad Asghar, Syed Ali Rukh Pirzada, Amjad Ali, Masooma Hashmat, Tafazzul-E-Haque Mahmud, Sadia Asif, Aflak Rasheed |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Miliary tuberculosis Tuberculosis 030106 microbiology Case Report Microbiology Mycobacterium tuberculosis 03 medical and health sciences 0302 clinical medicine immune system diseases medicine skin and connective tissue diseases 030203 arthritis & rheumatology Autoimmune disease Proteinuria Systemic lupus erythematosus biology Intravenous methylprednisolone business.industry medicine.disease biology.organism_classification Dermatology Surgery Infectious Diseases Increased risk Parasitology medicine.symptom business |
| Zdroj: | Oxford Medical Case Reports |
| ISSN: | 2053-8855 |
| DOI: | 10.1093/omcr/omx030 |
| Popis: | Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently treated with high doses of corticosteroids and other immunosuppressive drugs. Thus patients with SLE are at increased risk for infections with several pathogens including Mycobacterium tuberculosis. There are no established guidelines available for treatment of tuberculosis in SLE patients with high disease activity due to lack of relevant studies and management based more on physician expertise. We report a case of a young SLE patient with high disease activity index (SLEDAI19) as evidenced by the presence of a vasculitic rash, non-healing ulcer on forearm and proteinuria of >1 g/d along with miliary tuberculosis. She was treated with intravenous methylprednisolone pulse up to 3 g and antituberculous therapy, but the result was a fatal outcome. This case report emphasizes the need for formal guidelines for co-management of active tuberculosis and SLE with high disease activity. |
| Databáze: | OpenAIRE |
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