Coexisting systemic lupus erythematosus with lupus nephritis and sickle cell trait: a case report of rare combination.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2025-05-21 eCollection Date: 2025-06-01 DOI:10.1097/MS9.0000000000003291
Hari Sedai, Suraj Shrestha, Roshan Aryal, Suman Acharya, Sugat Adhikari, Nabin Karki
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Abstract

Introduction and importance: Systemic lupus erythematosus (SLE) and sickle cell disease (SCD) are relatively common disorders but their coexistence in an individual is rare. Because of the similarities in the musculoskeletal, central nervous system, and renal manifestations in both diseases, diagnosis of SLE in patients with SCD can be difficult to establish. Both the SCD and sickle cell trait (SCT) can have a cumulative assault in the progression of chronic kidney disease (CKD).

Case presentation: We report a case of a 23-year-old female from an endemic region of SCD in Nepal who presented initially with the symptoms of urinary tract infection but was diagnosed later to have coexistent SCT with SLE. A biopsy of the kidney was done where evidence of lupus nephritis was found with no evidence of sickle cell nephropathy. She was managed with immunosuppressive medications.

Clinical discussion: Although SCT and SLE are infrequently described combined, their related clinical characteristics, such as chronic progression and renal involvement, make identification more difficult. A renal biopsy is frequently necessary to distinguish between lupus nephritis, which is caused by autoimmune processes, and SCT-related kidney injury, which is associated with modest and localized sickling of red blood cells. Accurate identification of renal abnormalities is critical for guiding treatment and improving patient outcomes.

Conclusions: Both SCT and SLE can have multisystem manifestations with positive anti-nuclear antibodies. The coexistence of both can accelerate the rate of kidney damage but isn't always the same as it may differ from case to case.

系统性红斑狼疮合并狼疮肾炎及镰状细胞特征:罕见合并1例。
简介和重要性:系统性红斑狼疮(SLE)和镰状细胞病(SCD)是相对常见的疾病,但在个体中共存是罕见的。由于两种疾病在肌肉骨骼、中枢神经系统和肾脏表现上的相似性,SCD患者SLE的诊断可能难以确定。SCD和镰状细胞特征(SCT)在慢性肾脏疾病(CKD)的进展中都有累积性攻击。病例介绍:我们报告一例来自尼泊尔SCD流行地区的23岁女性,她最初表现为尿路感染症状,但后来被诊断为SCT与SLE共存。肾活检发现狼疮肾炎的证据,没有镰状细胞肾病的证据。她接受了免疫抑制药物治疗。临床讨论:虽然SCT和SLE合并的情况很少,但它们的相关临床特征,如慢性进展和肾脏受累,使得鉴别更加困难。为了区分狼疮性肾炎(由自身免疫过程引起)和sct相关的肾损伤(与中度和局部红细胞镰状细胞相关),肾活检经常是必要的。准确识别肾脏异常对于指导治疗和改善患者预后至关重要。结论:SCT和SLE均有多系统表现,抗核抗体阳性。两者的共存会加速肾脏损害的速度,但并不总是一样的,因为它可能因情况而异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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