J Rheum Dis.  2014 Oct;21(5):270-273. 10.4078/jrd.2014.21.5.270.

Renal Infarction in Antiphospholipid Antibody-negative Pediatric Systemic Lupus Erythematosus Patient

• Kim SH
• Choe JY
• Kim SK
• Park SH
• Baek SA
• Lee H

• KMID: 2222953
• DOI: http://doi.org/10.4078/jrd.2014.21.5.270

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple organ systems, and is characterized by the deposition of immune complexes and a large array of autoantibodies. Thrombosis is a relatively frequent and serious complication of SLE; however, renal infarction in young patients with antiphospholipid antibody-negative lupus has rarely been reported, and no pediatric case has been reported in Korea. A 12-year-old female patient was presented to our hospital with a 3-day history of nausea, vomiting, and right flank pain. She was diagnosed with SLE and lupus nephritis two years ago and was treated with corticosteroids and hydroxychloroquine, azathioprine. Abdominal computed tomography (CT) showed renal infarction in the upper pole of the right kidney. Subcutaneous low molecular weight heparin was started, and warfarin was also started simultaneously and continued for 3 months. After 3 months, only minimal atrophic changes were seen on the abdominal CT. She is doing well by maintaining oral anticoagulant therapy and is being followed up regularly through outpatient clinic visits.

Keyword

Systemic lupus erythematous; Renal infarction; Antiphospholipid antibodies

MeSH Terms

Adrenal Cortex Hormones
Ambulatory Care Facilities
Antibodies, Antiphospholipid
Antigen-Antibody Complex
Autoantibodies
Autoimmune Diseases
Azathioprine
Child
Female
Flank Pain
Heparin, Low-Molecular-Weight
Humans
Hydroxychloroquine
Infarction*
Kidney
Korea
Lupus Erythematosus, Systemic*
Lupus Nephritis
Nausea
Thrombosis
Tomography, X-Ray Computed
Vomiting
Warfarin
Adrenal Cortex Hormones
Antibodies, Antiphospholipid
Antigen-Antibody Complex
Autoantibodies
Azathioprine
Heparin, Low-Molecular-Weight
Hydroxychloroquine
Warfarin

Figure

• 

  Figure 1. Abdominal CT showing a 2.2 cm sized heterogeneous hypodense lesion in the upper pole of the right kidney.

• 

  Figure 2. Focal atrophic changes in the upper pole of the right kidney.

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