Diagnosis of TB Granuloma in SLE Patient by Kidney Biopsy
DOI:
https://doi.org/10.54361/LJM18.08Keywords:
systemic lupus erythematosus, tuberculosis, immunocompromised, granulomaAbstract
Lupus Nephritis is a common clinical manifestation affecting more than 50% of patients with Systemic Lupus Erythematosus (SLE), a chronic autoimmune disease that can affect virtually any organ. Whilst lupus nephritis is typically detected by an abnormal urinalysis with or without an elevated plasma creatinine, diagnosis is confirmed on renal biopsy. It is characterized by immunologic abnormalities including formation of immunocomplex deposits affecting the glomerular basement membrane, mesangium and/or subendothelial. It is by nature an immunocompromised state and along with its immunosuppressive treatment, lupus nephritis places a patient at high risk of opportunistic infections, including Tuberculosis (TB). A 21-year-old female presented with clinical features suggestive of lupus nephritis and a preserved renal function. The diagnosis was later confirmed on renal biopsy with an incidental finding of TB on renal histopathology. Interestingly, the patient had no constitutional symptoms or clinical history suggestive of TB. Antituberculosis treatment was initiated and mycophenolate, enalapril and prednisone was boarded after 2 weeks of TB treatment. The patient was later lost to follow up due to defaulting chronic treatment and follow up.
Downloads
References
Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365(22):2110-21.
Zumla A, Raviglione M, Hafner R, von Reyn CF. Tuberculosis. N Engl J Med. 2013;368(8):745-55.
Kim HY, Im JG, Goo JM, Lee JK, Song JW, Kim SK. Pulmonary tuberculosis in patients with systematic lupus erythematosus. AJR Am J Roentgenol. 1999 Dec;173(6):1639-42. doi: 10.2214/ajr.173.6.10584813. PMID: 10584813.Zandman-Goddard G, Shoenfeld Y. Infections and SLE. Autoimmunity. 2005;38(7):473-85.
Duran, S., Aksu, K., & Akpolat, T. (2021). Non-lupus nephritis in systemic lupus erythematosus patients with kidney biopsy: a retrospective study. Rheumatology International, 41(3), 593-601. doi: 10.1007/s00296-020-04771-5
Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365(22):2110-21.
Chen M, D’Souza S, Sun J. The impact of systemic lupus erythematosus on the immunopathogenesis of tuberculosis. J Immunol Res. 2015;2015:620601.
Chen M, D’Souza S, Sun J. The influence of tuberculosis on the clinical course of systemic lupus erythematosus. Clin Rheumatol. 2016;35(7):1649-56.
Chen M, D’Souza S, Zhang Q, Wang F, Sun J. Histopathological analysis of pulmonary tuberculosis in systemic lupus erythematosus. BMC Infect Dis. 2013;13:558.
Liu Y, Tan W, Sun L, Liu Y, Wang J, Li Z, et al. Cytokines and chemokines in Mycobacterium tuberculosis infection. Mol Immunol. 2019;114:139-47
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Chloe Declercq, Lincoln Lunga Khoza, Salah Bashir (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Open Access Policy
Libyan journal of medical Research (LJMR).is an open journal, therefore there are no fees required for downloading any publication from the journal website by authors, readers, and institution.
The journal applies the license of CC BY (a Creative Commons Attribution 4.0 International license). This license allows authors to keep ownership f the copyright of their papers. But this license permits any user to download , print out, extract, reuse, archive, and distribute the article, so long as appropriate credit is given to the authors and the source of the work.
The license ensures that the article will be available as widely as possible and that the article can be included in any scientific archive.
Editorial Policy
The publication of an article in a peer reviewed journal is an essential model for Libyan journal of medical Research (LJMR). It is necessary to agree upon standards of expected ethical behavior for all parties involved in the act of publishing: the author, the journal editorial, the peer reviewer and the publisher.
Any manuscript or substantial parts of it, submitted to the journal must not be under consideration by any other journal. In general, the manuscript should not have already been published in any journal or other citable form, although it may have been deposited on a preprint server. Authors are required to ensure that no material submitted as part of a manuscript infringes existing copyrights, or the rights of a third party.
Authorship Policy
The manuscript authorship should be limited to those who have made a significant contribution and intellectual input to the research submitted to the journal, including design, performance, interpretation of the reported study, and writing the manuscript. All those who have made significant contributions should be listed as co-authors.
Others who have participated in certain substantive aspects of the manuscript but without intellectual input should only be recognized in the acknowledgements section of the manuscript. Also, one of the authors should be selected as the corresponding author to communicate with the journal and approve the final version of the manuscript for publication in the LJMR.
Peer-review Policy
- All the manuscripts submitted to LJMR will be subjected to the double-blinded peer-review process;
- The manuscript will be reviewed by two suitable experts in the respective subject area.
- Reports of all the reviewers will be considered while deciding on acceptance/revision or rejection of a manuscript.
- Editor-In-Chief will make the final decision, based on the reviewer’s comments.
- Editor-In-Chief can ask one or more advisory board members for their suggestions upon a manuscript, before making the final decision.
- Associate editor and review editors provide administrative support to maintain the integrity of the peer-review process.
- In case, authors challenge the editor’s negative decision with suitable arguments, the manuscript can be sent to one more reviewer and the final decision will be made based upon his recommendations.
