Document Detail


Sun-induced life-threatening lupus nephritis.
MedLine Citation:
PMID:  17893968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Photosensitivity is a widely known characteristic of both cutaneous and systemic lupus erythematosus (LE). However, sun-induced organ involvement is rarely reported in LE. We describe a 34-year-old woman who had been in complete remission of systemic LE for more than 8 years without treatment. After sunbathing, she developed acute sunburn followed by cutaneous LE in sun-exposed areas. Six weeks later, a lupus nephritis was diagnosed and high serum levels of antidouble-stranded (ds) DNA and anti-Ro/SSA antibodies were detected. Treatment with systemic cyclophosphamide and prednisolone led to septicemia requiring assisted ventilation for more than 2 weeks and repeated hemodialysis. Clinical remission was achieved 3 months later by the use of prednisolone and mycophenolate mofetile. Meanwhile, mild proteinuria persisted, anti-dsDNA antibodies normalized. We hypothesize that the sunburn-induced keratinocyte necrosis/apoptosis exposed intracellular antigens as trigger for the generation of autoantibodies that finally mediated immune-complex nephritis. The patient highlights the impact of UV light not only on skin but also on internal organ involvement in LE.
Authors:
Enno Schmidt; Hans-Peter Tony; Eva-Bettina Bröcker; Christian Kneitz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1108     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-09-25     Completed Date:  2007-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-40     Citation Subset:  IM    
Affiliation:
Department of Dermatology, University of Würzburg, Würzburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Antinuclear / blood
Female
Humans
Lupus Nephritis / blood,  etiology*,  physiopathology
Photosensitivity Disorders / blood,  physiopathology*
Sunburn
Sunlight / adverse effects*
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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