Palleti Sujith K, Picken Maria M, Wadhwa Anuradha
Department of Internal Medicine/Nephrology, Edward Hines Jr. Veterans Administration Hospital, Hines, USA.
Department of Internal Medicine/Nephrology, Loyola University Medical Center, Maywood, USA.
Cureus. 2023 May 7;15(5):e38666. doi: 10.7759/cureus.38666. eCollection 2023 May.
Overlap syndrome is a connective tissue disorder that satisfies the diagnostic criteria for at least two well-known autoimmune diseases. In this report, we describe a rare case of lupus overlap in an elderly woman with primary Sjögren's syndrome who presented with features of nephritic-nephrotic syndrome and renal biopsy results typical of lupus nephritis combined with multiple positive autoantibodies. The kidney biopsy results were assigned the highest weightage based on the revised 2019 systemic lupus erythematosus (SLE) classification criteria developed by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). The patient's condition significantly improved after appropriate immunosuppressive therapy was initiated. With the revised ACR/EULAR-2019 criteria, we anticipate that more SLE patients with typical lupus nephritis biopsy findings will be diagnosed accurately.
重叠综合征是一种结缔组织疾病,符合至少两种知名自身免疫性疾病的诊断标准。在本报告中,我们描述了一例罕见的老年女性狼疮重叠病例,该患者患有原发性干燥综合征,表现为肾炎-肾病综合征特征,肾活检结果为典型的狼疮性肾炎,并伴有多种自身抗体阳性。根据欧洲抗风湿病联盟(EULAR)和美国风湿病学会(ACR)制定的2019年修订的系统性红斑狼疮(SLE)分类标准,肾活检结果被赋予最高权重。在开始适当的免疫抑制治疗后,患者的病情显著改善。基于修订后的ACR/EULAR-2019标准,我们预计将有更多具有典型狼疮性肾炎活检结果的SLE患者得到准确诊断。