Overlap syndrome in late-onset systemic lupus erythematosus with lupus nephritis and MPO-ANCA pauci-immune glomerulonephritis and tuberculosis: an uncommon association
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Fecha
2025
Autores
Dulce Muñoz, Jaime Arturo
Aroca-Martinez, Gustavo
Seni, Christian
Perea Rojas, Diana Marcela
CABARCAS BARBOSA, OMAR
Niño Hernández, Lucia Mercedes
Gaivao Arciniegas, Dario Jose
García Jarava, Camila Maria
Olivares Olmos, Marianela
Seni Hernandez, Sebastian Andre
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Editor
Wiley
Resumen
Systemic lupus erythematosus is a systemic autoimmune pathology that generally presents in young people and manifests acutely,
while its late presentation in people over 50 years of age is rare and insidious. Vasculitis is a pathology that afects any vessel
producing fbrinoid necrosis, and presents with a positive antineutrophil cytoplasmic antibody. Te concomitance of these two
entities is rare and leads to worse clinical outcomes. We present a 73-year-old female patient who presented with rapidly
progressive glomerulonephritis requiring renal replacement therapy, pulmonary tuberculosis, late-onset lupus erythematosus
with lupus nephritis, and a positive result for neutrophil cytoplasmic antibody. An immune-mediated extracapillary proliferative
glomerulonephritis was found when the biopsy was performed, with obvious signs of vasculitis, an overlap syndrome was found
between these entities. She was initially treated with antituberculosis therapy, boluses of methylprednisolone and continued with
intermittent renal replacement therapy; however, due to the severity of his pathologies, she had a fatal outcome. Te concomitance
between these autoimmune pathologies is unusual; there is a late-onset overlap syndrome between lupus nephritis accompanied
by myeloperoxidase-antineutrophil cytoplasmic antibody and pauci-immune glomerulonephritis. Te dual presentation es tablishes clinical challeng.
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ANCA
