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Lupus nephropathy and cardiopulmonary and hepatic dysfunctions in a child

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Abstract

Systemic lupus erythematosus (SLE) is a potentially fatal autoimmune multi-systemic rheumatologic disorder. An unusual case is reported of an 11.9-year-old Nigerian girl who was diagnosed after 2.8 years of non-specific symptoms and six episodes of recurrent haemolysis and pancytopaenia warranting blood transfusions. At diagnosis, she had hepatitis, polyarthritis, nephropathy, and cardiopulmonary and bone-marrow dysfunctions. Lymphopaenia, thrombocytopaenia, and direct antiglobulin-test positive haemolytic anaemia were present. Rapid resolution of disease activity followed exchange blood transfusion after an initial poor response to corticosteroid and cyclophosphamide therapy. Any child with recurrent haemolysis and pancytopaenia of unknown aetiology should be investigated for SLE.

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References

  1. Fessel WJ (1988) Epidemilogy of systemic lupus erythematous. Rheum Dis Clin North Am 14:15–23

    PubMed  CAS  Google Scholar 

  2. Faller G, Thomson PD, Kala UK, Hahn D (2005) Demographics and presenting clinical features of childhood systemic lupus erythematosus. S Afr Med J 95:424–427

    PubMed  CAS  Google Scholar 

  3. Brandt JT, Triplett DA, Alving B, Scharrer J (1995) Criteria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost 74:185–190

    Google Scholar 

  4. International Society of Nephrology and Renal Pathology Society Working Group on the Classification of Lupus Nephritis (2004) The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int 65:521–530

    Article  Google Scholar 

  5. Foster BJ, Bernard C, Drummond KN, Sharma AK (2000) Effective therapy for severe Henoch-Schonlein purpura nephritis with prednisone and azathioprin: a clinical and histopathologic study. J Pediatr 136:370–375

    Article  PubMed  CAS  Google Scholar 

  6. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Wincester RJ (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum l 25:1271–1277

    Article  CAS  Google Scholar 

  7. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725

    Article  PubMed  CAS  Google Scholar 

  8. Bader-Meunier B, Armengaud JB, Haddad E, Salomon R, Deschenes G, Kone-Paut I, Leblanc T, Loirat C, Niaudet P, Piette JC, Prieur AM, Quartier P, Bouissou F, Foulard M, Leverger G, Lemelle I, Pilet P, Rodiere M, Sirvent N, Cochat P (2005) Initial presentation of childhood-onset systemic lupus erythematosus: a French multicenter study. J Pediatr 146:648–653

    Article  PubMed  CAS  Google Scholar 

  9. Bakr A (2005) Epidemiology, treatment and outcome of childhood systemic lupus erythematosus in Egypt. Pediatr Nephrol 20:1081–1086

    Article  PubMed  Google Scholar 

  10. Erbey F, Cuhaci A, Incecik F, Noyan A, Altintas DU, Tuncer I, Duran F (2005) Neonatal lupus erythematosus presenting with cholestatic hepatitis: a case report and review of the literature. Turk J Pediatr 47:63–66

    PubMed  Google Scholar 

  11. Kawai T, Tominaga S, Okouchi A, Kudo M, Katoh K, Shoda M, Fujino MA (2005) A case of systemic lupus erythematosus presenting with jaundice and lupus pneumonia. Arerugi 54:76–80

    PubMed  Google Scholar 

  12. Jacobs JC (1977) Treatment of systemic lupus erythematosus in childhood. Arthritis Rheum 20:304–307

    Article  PubMed  CAS  Google Scholar 

  13. Bogdanovic R, Nikkolic V, Pasic S, Dimitrijevic J, Lipkovska-Markovic J, Eric-Marinkovic J, Ognjanovic M, Minic A, Stajic N (2004) Lupus nephritis in childhood: a review of 53 patients followed at a single center. Pediatr Nephrol 19:36–44

    Article  PubMed  Google Scholar 

  14. D’Agati VA (1998) Renal disease in systemic lupus erythematosus, mixed connective tissue disease, Sjogren’s syndrome, and rheumatoid arthritis. In: Jennette JC, Olson JL, Schwartz MM, Silva FG (eds) Heptinstall’s pathology of the kidney, 5th edn. Lippincott-Raven, Philadelphia, pp 541–624

    Google Scholar 

  15. Phadke K, Trachtmann H, Nicastri A, Chen CK, Tejani A (1984) Acute renal failure as the initial manifestation of syndromic lupus erythematosus in children. J Pediatr 105:38–41

    Article  PubMed  CAS  Google Scholar 

  16. Ponticelli C, Imbasciati E, Branchoccio D, Tarantion A, Rivolta E (1974) Acute renal failure in systemic lupus erythematosus. Br Med J 3:716–719

    Article  PubMed  CAS  Google Scholar 

  17. Cunningham E, Brentjens J, Venuto R (1978) Acute renal failure secondary to interstitial lupus nephritis. Arch Intern Med 138:1560–1561

    Article  PubMed  CAS  Google Scholar 

  18. Marks SD, Shah V, Pilkington C, Woo P, Dillon MJ (2005) Renal tubular dysfunction in children with systemic lupus erythematosus. Pediatr Nephrol 20:141–148

    Article  PubMed  Google Scholar 

  19. Lockwood CM, Pinching AJ, Sweny P, Rees AJ, Passell B, Uff J, Peters DK (1977) Plasma exchange and immunosuppression in the treatment of fulminating immune-complex glomerulonephritis. Lancet 1:63–67

    Article  PubMed  CAS  Google Scholar 

  20. Lewis EJ, Hunsicker LG, Lan SP, Rhode RD, Lachin JM (1992) A controlled trial of plasmapheresis in severe lupus nephritis. N Engl J Med 326:1373–1379

    Article  PubMed  CAS  Google Scholar 

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Acknowledgement

Dr. Adelusola KA, Histopathology Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, reported the histopathology slides and provided the renal photomicrographs.

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Authors and Affiliations

  1. Paediatric Nephrology and Hypertension Unit, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Osun State, Nigeria

    Wasiu Adekunle Olowu

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  1. Wasiu Adekunle Olowu
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Correspondence to Wasiu Adekunle Olowu.

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Olowu, W.A. Lupus nephropathy and cardiopulmonary and hepatic dysfunctions in a child. Pediatr Nephrol 21, 1318–1322 (2006). https://doi.org/10.1007/s00467-006-0156-9

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  • DOI: https://doi.org/10.1007/s00467-006-0156-9

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