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LETTER TO THE EDITOR |
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Year : 2016 | Volume
: 9
| Issue : 2 | Page : 276 |
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The old man with heavy proteinuria: An uncommon case of lupus nephropathy in elderly male
Nikhil Gupta
Department of Clinical Immunology and Rheumatology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
Date of Web Publication | 1-Mar-2016 |
Correspondence Address: Nikhil Gupta C-158, Pushpanjali Enclave, Pitampura, New Delhi - 110 034 India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0975-2870.167970
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 |
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 | | |
We thank the author for writing this letter regarding this issue and for clarifying the new diagnostic criteria for SLE that is, SLICC.
References | | |
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. |
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. |
3. | Lien YH, Lai LW. Pathogenesis, diagnosis and management of paraneoplastic glomerulonephritis. Nat Rev Nephrol 2011;7:85-95. |
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