An Antinuclear Antibody-Negative Patient With Lupus Nephritis.
10.3904/kjim.2009.24.1.76
- Author:
Hyoun Ah KIM
1
;
Jae Wook CHUNG
;
Han Jung PARK
;
Dai Yeol JOE
;
Hyun Ee YIM
;
Hae Sim PARK
;
Chang Hee SUH
Author Information
1. Department of Allergy & Rheumatology, Ajou University School of Medicine, Suwon, Korea. chsuh@ajou.ac.kr
- Publication Type:Case Report
- Keywords:
Antinuclear antibody;
Lupus nephritis;
Systemic lupus erythematosus
- MeSH:
Adolescent;
Antibodies, Antinuclear/*immunology;
Biopsy;
Female;
Follow-Up Studies;
Humans;
Lupus Nephritis/diagnosis/*immunology;
Tomography, X-Ray Computed
- From:The Korean Journal of Internal Medicine
2009;24(1):76-79
- CountryRepublic of Korea
- Language:English
-
Abstract:
Systemic lupus erythematosus (SLE) is a typical autoimmune disease that's characterized by various autoantibodies to nuclear and cytoplasmic antigens. The presence of antinuclear antibodies (ANA) in serum is generally considered a decisive diagnostic sign of SLE. However, a small subset of SLE patients who had the typical clinical features of SLE was reported to show persistently negative ANA tests. Our report describes a 16-yr-old female who presented with the clinical manifestations of SLE such as malar rash, photosensitivity, arthritis, lymphopenia, pericarditis and proteinuria. The serum autoantibodies were all negative and renal biopsy showed that the histopathological changes of immune complex mediated the focal segmental necrotizing glomerulonephritis with crescent formation. She was treated with monthly pulse cyclophosphamide along with corticosteroids. During the 2-yr follow-up period, the proteinuria was markedly decreased and all of the ANA and anti-double stranded DNA antibody tests were negative. This case suggests that ANA may not be required in the pathogenesis of lupus nephritis.
