A recent case study reports on the co-occurrence of lupus erythematosus tumidus and lupus nephritis—an extremely rare manifestation of lupus—in a 38-year-old woman.
Systemic lupus erythematosus (SLE) is known for its diverse array of clinical manifestations, encompassing various organ systems. Among these, lupus nephritis and lupus erythematosus tumidus (LET) are uncommon presentations. However, the simultaneous coexistence of these two conditions at the onset of SLE remains a remarkable rarity.
Case Study Presents Complex Dynamics
In a case study published in the Journal of Medical Case Reports, a 38-year-old North African woman, presented to the nephrology department with lower extremity edema, fatigue, and a weight loss of 3 kg over 4 weeks.
A physical examination revealed LET lesions on her chest and neck. Laboratory investigations revealed numerous findings, including lymphopenia, low levels of complement C3 and C4, positive antinuclear antibodies, anti-dsDNA antibodies, and anti-SSA/Ro antibodies.
Renal function testing showed normal serum creatinine levels juxtaposed with nephrotic-range proteinuria. The subsequent renal biopsy revealed Class V lupus nephritis, while a skin biopsy affirmed the diagnosis of LET.
Diagnosis and Treatment
Based on the 2019 EULAR/ACR criteria, the patient was given an SLE diagnosis and was treated with prednisone and hydroxychloroquine. Marked improvements in both cutaneous and renal symptoms were noted at 6- and 12-month follow-ups.
A Unique Case Study
SLE is a multifaceted autoimmune disorder that displays an array of clinical features, often involving the skin and renal domains. While cutaneous involvement and renal complications are well-established, the confluence of LET and lupus nephritis as the initial indicators of SLE is an uncommon occurrence.
Hajji, M., Gorsane, I., Badrouchi, S., Litaiem, N., Rammeh, S., Hamida, F. B., & Abderrahim, E. (2023). Systemic lupus erythematosus presenting as lupus erythematosus tumidus and lupus nephritis: a case report. Journal of Medical Case Reports, 17(1). https://doi.org/10.1186/s13256-023-03981-3