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- 저자 : ( Filiberto Gomez ) (검색결과 1 건)
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Poster Session : PS 0725 ; Rheumatology ; Case Report: Elderly-Onset Systemic Lupus Erythematosus
( Ruben Gomez ),( Ericka Carrillo ),( Filiberto Gomez ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Elderly onset SLE contributes to 10% of all SLE and is considered a rare disease, the signs and symptoms are common to other more frequent diseases in this age so the differential diagnosis is wide and could represent a great clinical challenge. We report two cases, one patient presented with data of serositis, acute renal failure and glomerulonephritis; while the other had evidence of cerebral vasculitis. Case 1: 60 year old male with 6 months of asthenia, malaise and early-morning bilateral limb edema, received treatment with diuretics without improvement, presenting arterial hypertension. He was admitted with IV NYHA class Congestive HF and left pleural effusion. Laboratory reported Hb 14. 3 g/dl, leucocytes 5750 (normal differential count), ESR of 50 mm/h, creatinine 2. 1 mg/dl, urea 60 mg/dl, urinalysis was positive for albumin, hemoglobin and granular casts; GFR 35 ml/min, and 24-hour albuminuria 3. 8 g. ECHO showed a 68% LVEF and 150 ml pericardial effusion. Immunologic profi le showed positive ANA (1:140), positive anti-dsDNA (1:60), and positive anti-SM (1:65). Kidney biopsy showed focal-segmental glomerulonephritis. Case 2: 68 year-old female positive for Diabetes Mellitus and Arterial Hypertension treated with glibenclamide and captopril. She presented at ER with diplopia, bilateral internuclear ophthalmoplegia and bilateral limb paraparesis, initial head CT-scan was normal, so she was admitted to the hospital. A second simple and contrasted head CT-scan was also normal, then the head MRI showed vasculitis and the brain SPECT revealed hypocaptating areas in midbrain, frontal and parietal cortex. Laboratory reported Hb 13. 3 g/dl, leucocytes 2578, glycose 145 mg/dl, normal creatinine, hepatic profi le and urinalysis. Immunologic profi le reported negative ANA, positive anti-dsDNA (1:95) and positive anti-SM (1:120). Both patients received treatment with Cyclophosphamide and Methylprednisolone with great response.
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