New Onset Systemic Lupus Erythematous After Kidney Transplant: Case Report

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-09-01 DOI:10.1016/j.transproceed.2025.07.015

Alexandra Esteves , Andreia Henriques , Beatriz Fernandes , Pedro Fragoso , Clara Pardinhas , Marina Reis , Rita Leal , Luís Rodrigues , Maria Guedes Marques , Lídia Santos , Catarina Romãozinho , Helena Sá , Arnaldo Figueiredo

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引用次数: 0

Abstract

The diagnosis of new onset autoimmune diseases in kidney transplant patients is challenging with new onset SLE after kidney transplant being a rare condition, with very few cases reported. We describe a case of a kidney transplant patient who, after 9 years presented with intermittent fever and diarrhea, inflammatory migratory polyarthralgia, myalgias, cramps and an erythematous rash in the cleavage area. Immunological testing revealed positive antinuclear antibodies (ANA 1:640), anti–double-stranded DNA antibodies (53.2 IU/mL), and elevated beta-2 microglobulin (105.59 U/mL), leading to the diagnosis of de novo SLE according to EULAR/ACR 2019 criteria. Notably, the patient exhibited no evidence of renal involvement from the onset, with stable kidney function and normal urinary sediment throughout follow-up. Ten months after undergoing treatment with corticosteroids and belimumab there was partial clinical and serological improvement. This case highlights a rare presentation of post-transplant SLE without renal involvement, reinforcing the need for a high index of suspicion in transplant recipients presenting with non-specific inflammatory symptoms.

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肾移植后新发系统性红斑狼疮1例。

肾移植患者新发自身免疫性疾病的诊断具有挑战性，肾移植后新发SLE是一种罕见的疾病，很少有病例报道。我们描述了一例肾移植患者，9年后出现间歇性发烧和腹泻，炎症性迁移性多关节痛，肌痛，痉挛和乳沟区红斑皮疹。免疫检测显示抗核抗体阳性（ANA 1:640），抗双链DNA抗体阳性（53.2 IU/mL）， β -2微球蛋白升高（105.59 U/mL），根据EULAR/ACR 2019标准诊断为新生SLE。值得注意的是，患者从一开始就没有表现出肾脏受累的迹象，整个随访期间肾功能稳定，尿沉渣正常。在接受皮质类固醇和贝利单抗治疗10个月后，临床和血清学有部分改善。本病例强调了移植后SLE不累及肾脏的罕见表现，加强了对移植受者出现非特异性炎症症状的高度怀疑的必要性。

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

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.