Nov 15, 2019

Systemic lupus erythematosus in a patient with multiple system atrophy: A case report

Medicine
Dimitrios PilalasChristos Savopoulos

Abstract

Multiple system atrophy is a late-onset rare neurodegenerative movement disorder which results in debilitating disease. Fever frequently ensues in the context of infections which can be associated with significant morbidity and mortality, but among alternative diagnostic possibilities neoplasms and autoimmune disorders should be considered. We describe a case of a prolonged febrile syndrome in a 55-year-old female patient with onset of multiple system atrophy two years before presentation. Patient history and symptoms were not contributive to guide the diagnostic work-up. Initial evaluation provided no specific findings. Repeat testing of auto-antibodies revealed positive antinuclear and anti-ds DNA antibodies coupled with low complement which in conjunction with renal biopsy substantiated the diagnosis of systemic lupus erythematosus flare. Pending the biopsy result, treatment with hydroxychloroquine and corticosteroids was initiated. Due to failure to achieve remission, azathioprine was added, but symptoms persisted. Following the diagnosis of lupus nephritis, azathioprine was discontinued and induction treatment with cyclophosphamide in accordance with the Euro-Lupus regimen was initiated and upon completion followed by main...Continue Reading

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Mentioned in this Paper

Treatment Protocols
Cyclophosphamide
Hydroxychloroquine
Mycophenolate mofetil
Neoplasms
Azathioprine
Evaluation
Autoimmune Diseases
Biopsy
Lupus Nephritis

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