Table of Contents  
LETTER TO THE EDITOR
Year : 2016  |  Volume : 9  |  Issue : 2  |  Page : 276  

The old man with heavy proteinuria: An uncommon case of lupus nephropathy in elderly male


Department of Clinical Immunology and Rheumatology, Christian Medical College Hospital, Vellore, Tamil Nadu, India

Date of Web Publication1-Mar-2016

Correspondence Address:
Nikhil Gupta
C-158, Pushpanjali Enclave, Pitampura, New Delhi - 110 034
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.167970

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How to cite this article:
Gupta N. The old man with heavy proteinuria: An uncommon case of lupus nephropathy in elderly male. Med J DY Patil Univ 2016;9:276

How to cite this URL:
Gupta N. The old man with heavy proteinuria: An uncommon case of lupus nephropathy in elderly male. Med J DY Patil Univ [serial online] 2016 [cited 2024 Mar 28];9:276. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2016/9/2/276/167970

Sir,

I want to congratulate the authors. [1] for diagnosing and successfully managing a case of late onset lupus nephritis.

The author mentions that the diagnosis of systemic lupus erythematosus (SLE) was made by according to the new revised American College of Cardiology/European League against Rheumatism classification criteria where renal biopsy suggestive of lupus and positive.

Anti-nuclear antibodies and/or anti-double stranded-DNA clinched the diagnosis. [1] However, I want to clarify that it is the Systemic Lupus International Collaborating Clinics classification criteria [2] 2012 that the patient mentioned in the case report fulfills.

There is an increased risk of malignancy as the age advances. Furthermore, malignancy such as thymoma has an association with autoimmune disease like lupus erythematosus. [3] Even there are reports of lupus nephritis manifesting as a paraneoplastic syndrome to renal cell carcinoma. [4] Moreover, membranous glomerulonephritis is commonly associated with malignancy such as non-Hodgkin lymphoma, solid tumors and chronic lymphocytic leukemia. [3] Some of the cancers have immunogenic features, which can lead to positivity of various antibodies. So malignancy screening should always be done in a patient presenting at an old age for the diseases such as SLE.


  Acknowledgment Top


We thank the author for writing this letter regarding this issue and for clarifying the new diagnostic criteria for SLE that is, SLICC.

 
  References Top

1.
Das SK, Biswas U, Biswas S, Jana CK. The old man with heavy proteinuria: An uncommon case of lupus nephropathy in elderly male. Med J DY Patil Univ 2015; 8:81-3.  Back to cited text no. 1
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2.
Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012;64:2677-86.  Back to cited text no. 2
    
3.
Lien YH, Lai LW. Pathogenesis, diagnosis and management of paraneoplastic glomerulonephritis. Nat Rev Nephrol 2011;7:85-95.  Back to cited text no. 3
    
4.
Tojo A. Paraneoplastic Glomerulopathy Associated with Renal Cell Carcinoma. Available from: . [Last accessed on 2015 Mar 14].  Back to cited text no. 4
    




 

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