Rheumatoid Arthritis Overlaping with Lupus Nephritis

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  • Rheumatoid arthritisにoverlapしたlupus nephritisについて
  • Rheumatoid arthritis ニ overlapシタ lupus

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Patient T.S., a 51-year-old woman, suffered from rheumatoid arthritis at 25 years old and got a remarkable deformity of her fingers at 40 years old. At that time, She was noticed to have hypertension andd proteinuria. On, She suffered from acute tonsillitis and then got a high fever and general edema. On, She was admitted to our hospital. On admission, BP was 186-104 mmHg, BT was 38.8°C, general edema and pericardial-and pleural effusion and ascites was found. The laboratory data were as follows; WBS 2100/mm3, ESR 120 mm (1°) IgG 2300 mg/dl, RA test positive, ANF positive (diffuse pattern) and marked hypocomplementemia. She had a profound proteinuria (4-5g/day) and showed the nephrotic syndrome. Her renal function was severely decreased (GFR 15.3ml/min, RPF 171.7ml/min). The renal biopsy specimens showed active lupus nephritis (MPGN type) by light microscopy and subendotherial dense deposit and segmental circumferential mesangial interposition by electron microscopy. By immunofluorescent microscopy, IgG, IgA, β1C, C1q and C4 was stained granular along the capillary walls and mesangium. We reported a rare overlaping case who suffered from calssical RA which satisfied the criteria of BRA, suffered about 26 years later from lupus nephritis which also satisfied the criteria of ARA.

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