Systemic lupus erythematosus and dermatomyositis with symptomatic bilateral sacroiliitis: an unusual and interesting association

Chandrasekhara, Pradeep Kumar Shenoy; Jayachandran, Nambiar Veettil; Thomas, Joe; Narsimulu, G

doi:10.1007/s10165-008-0120-6

Cited by 10 publications

(12 citation statements)

References 14 publications

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“…Interestingly, most of the reported patients with the coexistence of SLE and AS, including the present case, are female (F/M: 6/3). In most cases, including the present case, SLE symptoms preceded those of AS (F/M: 5/4) (4,5,6,9). On the other hand, the association between HLA-B27 and AS is well known, and the HLA-B27 molecule plays a role in the pathogenesis of AS.…”

Section: Discussionsupporting

confidence: 46%

“…These two autoimmune rheumatologic diseases, which have a different aetiopathogenesis as well as diverse clinical and genetic characteristics, are rarely seen together. To the best of our knowledge, there are only 8 reported cases of the coexistence of SLE and AS in the English literature (3)(4)(5)(6)(7)(8)(9)(10). Here, we report another case with the coexistence of these two diseases.…”

Section: Introductionmentioning

confidence: 76%

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Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature

Tarhan¹,

Argın²,

Can³

et al. 2014

Eur J Rheum

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The coexistence of systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) is very rare, and, to the best of our knowledge, there are only 8 reported cases in the English literature. Here, we present another case with the coexistence of these two diseases, and review the clinical and laboratory features of the previously reported cases. A 55 year-old female patient, with a diagnosis of SLE with locomotor, skin, renal and hematopoietic system involvement, which had been confirmed by relevant autoantibody positivity, and hypocomplementemia and biopsyproven membranous lupus nephritis, was referred to our clinic suffered from typical inflammatory low-back pain after eight years of follow-up. Sacroiliac magnetic resonance imaging (MRI) confirmed the presence of bilateral active sacroiliitis with bone marrow oedema. HLA-B27 was positive and bilateral calcaneal spurs were also detected by conventional radiography. Therefore, the additional diagnosis of AS was made, eight years after the diagnosis of SLE. Inflammatory low-back pain typically responded to treatment with non-steroidal anti-inflammatory drugs. Including the present case, most of the reported cases of the coexistence of SLE and AS are female, and SLE generally precedes the occurrence of AS. The present case is also notable as the patient had both MRI confirmation of bilateral active sacroiliitis and HLA-B27 positivity. The coexistence of these two diseases with different genetic backgrounds in the same patient is much lower than expected based upon their prevalence in the general population. Although it has been suggested that the very rare combination of the susceptibility genes of each disease may explain the rarity of coexistence, epidemiological data concerning the genetic risks for the coexistence of SLE and AS are not available.

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Section: Discussionsupporting

confidence: 46%

Section: Introductionmentioning

confidence: 76%

Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature

Tarhan¹,

Argın²,

Can³

et al. 2014

Eur J Rheum

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“…Systemic lupus erythematosus (SLE) belongs to a family of related autoimmune rheumatic disorders, including dermatomyositis, scleroderma, polymyositis, mixed connective tissue disease, and rheumatoid arthritis. All of these disorders are capable of affecting multiple organs, and the symptoms in systemic rheumatic diseases often overlap as has been repeatedly reported in the literature [1][2][3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Systemic Lupus Erythematosus with Severe Nephritis That Mimicked Henoch-Schoenlein Purpura

Al-Attrach

Al-Shibli²,

Al-Riyami³

et al. 2011

Arab J. Nephr. Trans

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Introduction: Systemic lupus erythematosus (SLE) belongs to a family of related autoimmune rheumatic disorders that are capable of affecting multiple organs, and they are all associated with a variety of autoantibodies. Henoch Schoenlein purpura (HSP) is a sort of systemic vasculitis that is not associated with auto-antibodies and can affect different organs including the kidneys.Case report: A 12 year-old girl presented with abdominal pain, low grade fever, swollen and tender feet and left hand, skin rash on the lower extremities, and high blood pressure. Initial laboratory tests revealed severe proteinuria, microscopic hematuria and low C3 level. Renal biopsy showed diffuse proliferative glomerulonephritis with IgA, fibrinogen and C3 deposits. The case was accordingly diagnosed as HSP with severe IgA nephropathy. Treatment was started with mycophenolate mofetil (MMF) and pulse methylprednisolone followed by prednisolone. The patient improved and treatment was discontinued after 5.5 months. One month after withdrawal of her medications, the patient presented again with serositis and recurrent proteinuria. Both antinuclear antibodies (ANA) and anti dsDNA were positive. At this point she was diagnosed to have SLE disease and immunosuppressive treatment was restarted. Following this, symptoms disappeared, proteinuria regressed and anti-dsDNA titer dropped. Conclusion:This case presented with features of HSP and was later-on diagnosed to have SLE. This kind of clinical overlapping has not been reported in the literature to the best of our knowledge.

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“…and is about the association of spondyloarthropathies and lupoid syndromes. Several case reports and studies, focusing on sacroiliitis in systemic lupus erythematosus (SLE) and other connective tissue diseases, have suggested that sacroiliac involvement could be a part of the clinical course . When we look at SSc, description of this rare association is demonstrated first in 1847 and cited by Benedek and Rodnan in 1982 .…”

Section: Introductionmentioning

confidence: 99%

Sacroiliac joint involvement in systemic sclerosis

et al. 2014

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Systemic lupus erythematosus and dermatomyositis with symptomatic bilateral sacroiliitis: an unusual and interesting association

Cited by 10 publications

References 14 publications

Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature

Coexistence of systemic lupus erythematosus and ankylosing spondylitis: another case report and review of the literature

Systemic Lupus Erythematosus with Severe Nephritis That Mimicked Henoch-Schoenlein Purpura

Sacroiliac joint involvement in systemic sclerosis

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