“Lupus eritematoso sistémico complicado en adulto”

Abstract

This is a 51-year-old female patient with a history of gastritis, cholelithiasis, knee osteoarthritis, rotator cuff tendonitis (right shoulder arthroscopy three years ago) and right carpal tunnel syndrome (median nerve release four years ago). Current clinical picture of six days of evolution with presence of pain of great intensity and edema that leaves fovea at the level of the posterior region of the right leg. At physical examination thorax decreased vesicular murmur, discrete crackles in right base; in lower right limb sign of Homans, positive Olow and Rosenthal, tortuous veins, slight edema ++ / +++, ECO DOPPLER is performed and thrombosis of the femoral and posterior tibial vein is diagnosed, initiating the treatment with anticoagulants (LMWH and Warfarin), is added to inflammatory type polyarthralgias, morning stiffness, swelling of the hands and knees. The value of positive rheumatoid factor and anti CCP negative, positive VSG and PCR give a picture of seropositive rheumatoid arthritis and it is requested: ANA, anti- DNA dc, anti- Smith, lupus anticoagulant reporting positive values, proteins in 24 hour urine: 718 mg, determining the diagnosis of systemic lupus erythematosus, lupus nephropathy and secondary antiphospholipid syndrome. In the presence of proteinuria, Nephrology is consulted and indicates the management of probable lupus nephropathy with ARA II and immunosuppressant’s.

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune,