A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis Patient
A 61-year-old woman with a 4-year history of maintenance hemodialysis due to end-stage renal disease of unknown cause was admitted because of a recurrent fever and abdominal pain lasting for 3 months. She had rheumatoid arthritis as a complication and had taken sulfasalazine for over 4 years. Labora...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-10-01
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| Series: | Clinical Medicine Insights: Case Reports |
| Online Access: | https://doi.org/10.1177/11795476211056172 |
| _version_ | 1818407679445434368 |
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| author | Shotaro Kosugi Tadashi Yoshida Norifumi Yoshimoto Hiroshi Itoh Mototsugu Oya |
| author_facet | Shotaro Kosugi Tadashi Yoshida Norifumi Yoshimoto Hiroshi Itoh Mototsugu Oya |
| author_sort | Shotaro Kosugi |
| collection | DOAJ |
| description | A 61-year-old woman with a 4-year history of maintenance hemodialysis due to end-stage renal disease of unknown cause was admitted because of a recurrent fever and abdominal pain lasting for 3 months. She had rheumatoid arthritis as a complication and had taken sulfasalazine for over 4 years. Laboratory data revealed thrombocytopenia, hypocomplementemia, a high C-reactive protein level, and positivity for antinuclear antibody and anti-double strand DNA antibody. Gallium scintigraphy showed pericarditis, pleuritis, and peritonitis. Nonscarring alopecia was also noted. She was diagnosed as having systemic lupus erythematosus (SLE). Drug-induced lupus elicited by sulfasalazine was ruled out because the symptoms did not improve even after the discontinuation of the drug upon admission. Oral prednisolone treatment markedly improved her symptoms and laboratory data. However, she later died of sepsis arising from proctitis on day 71 of admission. This report underscores the necessity of considering new-onset SLE in patients with unexplained fever and serositis, including pleuritis, peritonitis, or pericarditis, even if they are receiving maintenance dialysis. |
| first_indexed | 2024-12-14T09:31:40Z |
| format | Article |
| id | doaj.art-a2673242cf3444e7acb602a094b5154e |
| institution | Directory Open Access Journal |
| issn | 1179-5476 |
| language | English |
| last_indexed | 2024-12-14T09:31:40Z |
| publishDate | 2021-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Case Reports |
| spelling | doaj.art-a2673242cf3444e7acb602a094b5154e2022-12-21T23:08:03ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762021-10-011410.1177/11795476211056172A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis PatientShotaro Kosugi0Tadashi Yoshida1Norifumi Yoshimoto2Hiroshi Itoh3Mototsugu Oya4Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanApheresis and Dialysis Center, Keio University School of Medicine, Tokyo, JapanDepartment of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDepartment of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDepartment of Urology, Keio University School of Medicine, Tokyo, JapanA 61-year-old woman with a 4-year history of maintenance hemodialysis due to end-stage renal disease of unknown cause was admitted because of a recurrent fever and abdominal pain lasting for 3 months. She had rheumatoid arthritis as a complication and had taken sulfasalazine for over 4 years. Laboratory data revealed thrombocytopenia, hypocomplementemia, a high C-reactive protein level, and positivity for antinuclear antibody and anti-double strand DNA antibody. Gallium scintigraphy showed pericarditis, pleuritis, and peritonitis. Nonscarring alopecia was also noted. She was diagnosed as having systemic lupus erythematosus (SLE). Drug-induced lupus elicited by sulfasalazine was ruled out because the symptoms did not improve even after the discontinuation of the drug upon admission. Oral prednisolone treatment markedly improved her symptoms and laboratory data. However, she later died of sepsis arising from proctitis on day 71 of admission. This report underscores the necessity of considering new-onset SLE in patients with unexplained fever and serositis, including pleuritis, peritonitis, or pericarditis, even if they are receiving maintenance dialysis.https://doi.org/10.1177/11795476211056172 |
| spellingShingle | Shotaro Kosugi Tadashi Yoshida Norifumi Yoshimoto Hiroshi Itoh Mototsugu Oya A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis Patient Clinical Medicine Insights: Case Reports |
| title | A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis Patient |
| title_full | A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis Patient |
| title_fullStr | A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis Patient |
| title_full_unstemmed | A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis Patient |
| title_short | A Case of New-Onset Systemic Lupus Erythematosus With Serositis in a Maintenance Hemodialysis Patient |
| title_sort | case of new onset systemic lupus erythematosus with serositis in a maintenance hemodialysis patient |
| url | https://doi.org/10.1177/11795476211056172 |
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