Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
BMC Complement Med Ther. 2020 Jun 2;20(1):163. doi: 10.1186/s12906-020-02971-y.
Herbal medication is widely used in our region as a mode of alternative medicine. Its contents and combinations are often modified to suit the needs of different populations. These products are said to boost the immune system and may serve as a protective measure against many diseases including Systemic Lupus Erythematosus (SLE). Some even lay claims to be able to cure SLE. Although they are not without side effects, these medications are still preferred due to their widespread availability and affordability, compared to modern medications. However, to date, there have been no reported cases in which these traditional medications can trigger a lupus-like reaction, moreover one involving the kidneys.
We report a patient who developed overt lupus nephritis after consuming a course of herbal supplement. Her renal status did not improve upon cessation of the offending drug, and she required immunosuppressive therapy. After one cycle of IV cyclophosphamide, we managed to get the patient into remission - she is now on tapering doses of steroids.
We wish to highlight the possibility of consumption of herbal medication and the emergence of drug-induced lupus nephritis. A thorough anamnesis and high index of suspicion of drug-induced lupus nephritis is warranted when a patient on supplements presents with urinary abnormalities.
草药在我们地区被广泛用作替代医学的一种方式。其成分和组合经常被修改以适应不同人群的需求。这些产品据说可以增强免疫系统,并可能作为预防许多疾病的保护措施,包括系统性红斑狼疮 (SLE)。有些甚至声称能够治愈 SLE。尽管它们并非没有副作用,但与现代药物相比,由于这些药物广泛易得且价格实惠,因此仍被优先选用。然而,迄今为止,尚无报告称这些传统药物会引发狼疮样反应,更不用说涉及肾脏的反应了。
我们报告了一名患者,她在服用一疗程草药补充剂后出现明显的狼疮肾炎。停止使用该药物后,她的肾脏状况并未改善,需要免疫抑制治疗。在接受一轮 IV 环磷酰胺治疗后,我们成功使患者进入缓解期——她现在正在逐渐减少类固醇的剂量。
我们希望强调服用草药和出现药物诱导性狼疮肾炎的可能性。当服用补充剂的患者出现尿液异常时,应进行详细的病史询问,并高度怀疑药物诱导性狼疮肾炎。