Peritoneal dialysis in neuropsychiatric systemic lupus erythematosus: A case report integrating proteomic insights into complement-mediated mechanisms.

IF 1 4区医学 Q3 UROLOGY & NEPHROLOGY

Clinical nephrology Pub Date : 2025-09-05 DOI:10.5414/CN111812

Xinyu Wang, Litian Pu, Manxia Yu, Qinyuan Deng

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引用次数: 0

Abstract

Background: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a severe SLE complication with limited therapeutic options. While plasma exchange is used, it carries cardiovascular risks and logistical barriers.

Case report: We report a 42-year-old East Asian female with SLE who developed progressive edema, dyspnea, and seizures. Imaging and labs revealed cardiorenal dysfunction and neuroinflammatory signs. Peritoneal dialysis (PD) was initiated alongside immunosuppressive therapy (methylprednisolone, telitacicept, cyclophosphamide), leading to resolution of neuropsychiatric symptoms and improvement in renal and hematologic parameters. Proteomic findings: LC-MS/MS analysis of dialysate identified 518 proteins, with functional enrichment pointing to complement activation pathways. By day 4, levels of FCER2 (CD23) and C-reactive protein (CRP), both of which are associated with inflammation, were significantly downregulated, suggesting that PD may facilitate the removal of proinflammatory mediators.

Conclusion: PD may serve as a dual-purpose therapy in NPSLE, offering renal support and modulating complement overactivation.

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腹膜透析治疗神经精神系统红斑狼疮：一个病例报告整合蛋白质组学洞察补体介导的机制。

背景：神经精神系统性红斑狼疮（NPSLE）是一种严重的SLE并发症，治疗选择有限。虽然使用血浆交换，但它存在心血管风险和后勤障碍。病例报告：我们报告一位42岁的东亚女性SLE患者，她出现了进行性水肿、呼吸困难和癫痫发作。影像学和实验室检查显示心肾功能障碍和神经炎症征象。腹膜透析（PD）与免疫抑制治疗（甲基泼尼松龙、泰利他塞普、环磷酰胺）一起开始，导致神经精神症状的缓解，肾脏和血液参数的改善。蛋白质组学发现：透析液LC-MS/MS分析鉴定出518个蛋白质，功能富集指向补体激活途径。到第4天，与炎症相关的FCER2 （CD23）和c反应蛋白（CRP）水平显著下调，表明PD可能促进促炎介质的清除。结论：PD可作为NPSLE的双重治疗，提供肾脏支持和调节补体过度激活。

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

Clinical nephrology 医学-泌尿学与肾脏学

CiteScore

2.10

自引率

9.10%

发文量

138

审稿时长

4-8 weeks

期刊介绍： Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.