Das Dhriti Sundar, Sahoo Debananda
General Medicine, All India Institute of Medical Sciences, Bhubaneswar, IND.
Internal Medicine, All India Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2020 Aug 29;12(8):e10119. doi: 10.7759/cureus.10119.
The coexistence of systemic lupus erythematosus (SLE) with sickle cell trait is quite sparingly reported in literature. Here, we narrate the case of a 17-year-old girl from Eastern India with sickle cell trait who presented with acute lupus pneumonitis. The challenges to the final diagnosis of SLE with sickle cell trait were because of the often lesser degree of clinical suspicion at the outset. In this report, we discuss this not so uncommon combination of conditions and review related literature. This girl, who was a known case of sickle cell trait, presented with fever, cough, shortness of breath with subsequent rashes, oral ulceration, high erythrocyte sedimentation rate (ESR) and proteinuria. After ruling out infective causes, she was found to be antinuclear antibody (ANA) positive and with stage 4 lupus nephritis. Emphasis should be given to the presence of autoimmune conditions in patients with sickle hemoglobinopathies, including sickle cell trait wherein atypical or systemic involvement may occur. Such association holds more importance as sickle hemoglobinopathies is one of the major hemoglobinopathies reported in this part of the country.
系统性红斑狼疮（SLE）与镰状细胞性状共存的情况在文献中报道较少。在此，我们讲述一名来自印度东部的17岁患有镰状细胞性状的女孩，她出现了急性狼疮性肺炎。镰状细胞性状患者最终诊断SLE面临挑战，原因在于一开始临床怀疑程度往往较低。在本报告中，我们讨论这种并非罕见的病症组合并回顾相关文献。这名已知患有镰状细胞性状的女孩出现发热、咳嗽、呼吸急促，随后出现皮疹、口腔溃疡、高红细胞沉降率（ESR）和蛋白尿。排除感染性病因后，发现她抗核抗体（ANA）呈阳性且患有4期狼疮性肾炎。应重视镰状血红蛋白病患者中自身免疫性疾病的存在，包括镰状细胞性状，其中可能会出现非典型或全身性受累。这种关联更为重要，因为镰状血红蛋白病是该国该地区报告的主要血红蛋白病之一。
