Abstract: TH-PO1100
A Case of Newly Diagnosed Systemic Lupus Erythematosus and Lupus Nephritis After COVID-19 Infection
Session Information
- COVID-19 - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Clarke, Nicole Alexis, Larkin Community Hospital Inc, South Miami, Florida, United States
- Dande, Gabriela, Larkin Community Hospital Inc, South Miami, Florida, United States
- Gonzalez Montalvo, Saul N., Larkin Community Hospital Inc, South Miami, Florida, United States
Introduction
Systemic Lupus Erythematosus (SLE), the most common form of lupus, is a chronic autoimmune inflammatory disease with clinical manifestations affecting any organ. Kidney involvement is seen in about 50% of patients, leading to CKD or ESKD. The year 2019 brought on a pandemic caused by the virus Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we illustrate a case of SLE and lupus nephritis with clinical manifestations discovered after COVID-19 infection.
Case Description
A 39-year-old Hispanic male presented to our institution with abdominal pain associated with nausea and vomiting, recurrent skin rash, hematuria, weight loss of 40 pounds over the past several months and joint pains. Prior to this admission, he had multiple visits to the hospital for abdominal pain, general malaise, and joint pain that started about 9 months after a 5-day course of COVID-19 infection; and subsequently diagnosed with urticarial vasculitis with colitis during one of his hospital admissions. Physical examination was notable for tenderness to the epigastric and periumbilical region, and multiple umbilicated papules of the elbows and palms and tense bulla of the left third digit. His laboratory findings revealed elevated creatinine, anemia and urinalysis showed hematuria. Previous autoimmune workup was positive for ANA, ds-DNA, Sjogren’s antibodies and low C3 and C4 complements. His CT abdomen without contrast showed a thickened terminal ileum with inflammatory changes consistent with colitis. Skin biopsy findings were consistent with small vessel vasculitis. Subsequent renal biopsy confirmed immune complex – mediated glomerular nephritis with full house tubular inclusions and subepithelial deposits consistent with membranous lupus nephritis. He was treated with IV methylprednisolone, PO prednisone, with plans for starting Cyclophosphamide.
Discussion
The link between lupus and colitis is rare in the literature. Similarly, the link between lupus and COVID-19 is also rare with only case reports of both scenarios currently existing. This and other case reports in the literature hopes to spark the discussion and later the investigation as to the possible reasons for both occurrences.