Atrial thrombus as a complication of SLE and APS in an 8-year-old child.

Pediatric Rheumatology Online Journal
Hai-Bo Yan, Yu-Mei Li

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple systems with various clinical manifestations. Renal involvement is common, but intracardiac thrombus is rarely reported as a complication of antiphospholipid syndrome (APS, also known as anticardiolipin syndrome). Anticoagulant therapy is the first-line treatment, and surgery is performed in severe cases. We report a case to improve clinicians' understanding of disease diagnosis. An 8-year-old girl was admitted to our hospital because of left costal pain, hematuria and fever. She had obvious edema occult blood 3+, urinary protein 3.2 g/24 h, albumin 17.6 g/L, and total cholesterol 7.21 mmol/L, consistent with a diagnosis of nephrotic syndrome. We continued to track the etiology of nephrotic syndrome and performed a renal biopsy, showing dsDNA 1:10 positivity, low C3, low platelets and hemoglobin, anticardiolipin IgM 12 U/ml, anti-β2-glycoprotein I (β2GPI) 223 U/ml; renal pathology suggested lupus nephritis (LN), and the patient was ultimately diagnosed with SLE, secondary APS and LN. The patient was treated with hormones and immunosuppressants. Sixteen weeks later, her urinary protein was 1+, and the quantity of urine protein was less than 0.5 g/d. E...Continue Reading

References

Jan 14, 2004·Kidney International·Jan J WeeningUNKNOWN Renal Pathology Society Working Group on the Classification of Lupus Nephritis
Oct 28, 2004·Thrombosis Research·Guido Reber, Philippe de Moerloose
May 5, 2012·Arthritis Care & Research·Bevra H HahnUNKNOWN American College of Rheumatology
Jul 12, 2014·Current Opinion in Rheumatology·Noa SchwartzChaim Putterman
Jan 17, 2016·The Journal of Rheumatology·Andrea Hinojosa-AzaolaJorge Sanchez-Guerrero
Mar 31, 2019·Annals of the Rheumatic Diseases·Antonis FanouriakisDimitrios T Boumpas
Nov 5, 2019·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Eve Mary Dorothy SmithChristian Michael Hedrich

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Methods Mentioned

BETA
biopsy
light microscopy

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