Itikyala Sathish, Pattanaik Debendra, Raza Syed
University of Tennessee Health Science Center, Division of Rheumatology, Memphis, TN, USA.
Case Rep Rheumatol. 2019 Jan 6;2019:5013904. doi: 10.1155/2019/5013904. eCollection 2019.
We report here the first case of systemic lupus erythematosus (SLE) and antineutrophil cytoplasmic antibody-associated vasculitis overlap syndrome (SLE/AAV) who had granulomatous polyangiitis (GPA) as the initial presentation. SLE/AAV overlap syndrome is an uncommon entity recently described in the literature. Prior reported patients with SLE/AAV overlap syndrome presented with SLE and microscopic polyangiitis (MPA). Our patient initially presented with granulomatous gastric ulcer and later developed respiratory failure. She was diagnosed with GPA. While on maintenance treatment with azathioprine 150 mg/day, she developed hematuria and proteinuria which turned out to be from class V lupus nephritis instead of relapse of vasculitis. Currently, the patient is doing well after treatment with rituximab. Although rare, this entity should be recognized and need to be treated appropriately.
我们在此报告首例以肉芽肿性多血管炎（GPA）为首发表现的系统性红斑狼疮（SLE）与抗中性粒细胞胞浆抗体相关性血管炎重叠综合征（SLE/AAV）。SLE/AAV重叠综合征是一种最近在文献中有所描述的罕见病症。先前报道的SLE/AAV重叠综合征患者表现为SLE和显微镜下多血管炎（MPA）。我们的患者最初表现为肉芽肿性胃溃疡，随后发展为呼吸衰竭。她被诊断为GPA。在接受硫唑嘌呤150毫克/天维持治疗期间，她出现了血尿和蛋白尿，结果发现是来自Ⅴ类狼疮性肾炎而非血管炎复发。目前，该患者在接受利妥昔单抗治疗后情况良好。尽管这种情况罕见，但应予以识别并需要进行适当治疗。
