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Case Reports
. 2023;35(1):24.
doi: 10.1186/s43162-023-00208-1. Epub 2023 Mar 30.

Severe lupus after two years of hemodialysis: It exists and can be serious

Marouane Jabrane  1 , Mohammed Bouchoual  1 , Mohamed Arrayhani  1
Affiliations
Case Reports

Severe lupus after two years of hemodialysis: It exists and can be serious

Marouane Jabrane et al. Egypt J Intern Med. 2023.

Abstract

Progression of lupus nephropathy (LN) to end-stage renal disease is a serious complication and requires subsequent replacement therapy. Lupus disease activity is extinguished in chronic hemodialysis. We report the observation of a 35-year-old female patient, in conventionnel hemodialysis for two years (chronic glomerulonephritis), admitted to the emergency room for convulsions, left flaccid tenderness, cutaneous-mucosal pallor and altered general condition evolving since three days before her admission. we also observed a spontaneous ecchymotic lesions on the right arm. Echodoppler of the right upper extremity was in favor of a partially thrombosed aneurysm of the right brachial artery. The biological workup showed pancytopenia, the requested immunological workup showed a low complement C3, a positive level of anti-DNA antibodies. The patient was treated as severe lupus flare: Bolus of methylprednisolone, followed by oral administration, associated with Mycophenolate mofétil (MMF) at a dose of 1 g/d. The evolution was favorable on the clinical, biological and radiological levels. Systemic lupus erythematous (SLE) can occur even after several years of hemodialysis and sometimes in a severe form, pushing the clinician to think of this pathology in the presence of evocative signs.

Keywords: Hemodialysis; Lupus flare; Spontaneous ecchymosis.

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Conflict of interest statement

Competing interestsNone declared.

Figures

Fig. 1
Fig. 1
Spontaneous ecchymosis of the right arm with thrombosed aneurysm of the right brachial artery
Fig. 2
Fig. 2
Abdominal-pelvic CT scan shows a large hematoma of the right psoas muscle
See this image and copyright information in PMC

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