Y Lounici, A Hassan, D Khelifi Touhami, I Berkane and M Bouali Benhalima
Mustapha Bacha Teaching Hospital, Algeria
Posters & Accepted Abstracts: J Nephrol Ther
The objective of this work is to report and discuss the case of a patient who fulfilled the criteria for Systemic erythematosus lupus (SLE) and presented high rates of anti-proteinase 3 antibodies (anti-PR3). We report the case of a 68-year-old man who presented at the onset of the disease an important asthenia and a significant loss of weight (more than 10 kg in few months). He consulted for a sudden and severe dyspnea, chest pain and a fever. The clinical examination done by his doctor revealed a pleural effusion and an edema of his legs. Few weeks later, new symptoms appeared: Abdominal pain, arthralgias and proteinuria. An inflammatory syndrome was noticed at diagnosis with a high rate of CRP (CRP=96). Concerning the immunological tests, a very high titer of ANA (homogenous 1/1000) with positive anti-DNAn antibodies on crithidia luciliae was found. This patient had also a cytoplasmic- ANCA (c-ANCA) with a titer of 1/80 and his anti-PR3 antibodies were at a rate of 132 U/ml (Normal value<20 U/ml). Few cases of associations between SLE and AAV were reported in the literature and all of them had MPO-ANCAs. To the best of our knowledge, to date there have been no case reports of AAV with positive anti-PR3 antibodies in patients with SLE. The diagnosis of AAV in the setting of SLE is a real challenge and it├ó┬?┬?s crucial to establish it in order to choose the best treatment approach.
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