Abstract
SLE and SCD are relatively common disorders especially in India and Africa but the combination of connective tissue disease particularly SLE with SCD in a same individual appears to be rare. The actual incidence is not known because most of the published studies are case reports. Only 40 similar cases have been reported in the literature over the past 50 years. Because of the substantial overlap between the clinical features of these disorders, a clinical diagnosis of SLE in patients with SCD is difficult to establish.
Here, we report 2 cases presenting with musculoskeletal and renal complications with fever to the paediatric casualty of MKCG. The complications were initially thought due to SCD with sepsis but when there was no improvement after routine management of SCD, immunological markers were tested which came to be positive. Thus confirming the diagnosis of SLE with SCD.
Keywords: Connective tissue disease, Systemic lupus erythematosus (SLE), Sickle cell disease (SCD), immunological markers.
References
1. S. L. Gurevitz, J. A. Snyder, E. K. Wessel, J. Frey, and B. A. Williamson, “Systemic lupus erythematosus: a review of the disease and treatment options,” The Consultant Pharmacist, vol. 28, no. 2, pp. 110–121, 2013. View at Publisher · View at Google Scholar
2. Steinberg MH. Management of sickle cell disease. New Engl J Med. 1999;340:1021–1029. doi: 10.1056/NEJM19990401-3401307. [PubMed][Cross Ref]
3. V. R. Saxena, R. Mina, H. J. Moallem, S. P. Rao, and S. T. Miller, “Systemic lupus erythematosus in children with sickle cell disease,” Journal of Pediatric Hematology/Oncology, vol. 25, no. 8, pp. 668–671, 2003. View at Publisher · View at Google Scholar · View at Scopus
4. C. Toly-Ndour, A.-M. Rouquette, S. Obadia et al., “High titers of autoantibodies in patients with sickle-cell disease,” Journal of Rheumatology, vol. 38, no. 2, pp. 302–309, 2011. View at Publisher · View at Google Scholar · View at Scopus
5. Minocha V, Rana F. Lupus Nephritis in a Patient with Sickle Cell Disease. Case reports in hematology. 2013 Nov 7;2013.
6. N. A. Khalidi, H. Ajmani, and J. Varga, “Coexisting systemic lupus erythematosus and sickle cell disease: a diagnostic and therapeutic challenge,” Journal of Clinical Rheumatology, vol. 11, no. 2, pp. 86–92, 2005. View at Publisher · View at Google Scholar · View at Scopus
7. Wilson FM, Clifford GO, Wolf PL, Borges WH, Toone E, Pirani CL. Lupus erythematosus associated with sickle cell anemia. Arthritis & Rheumatology. 1964 Aug 1;7(4):443-50.
8. KABAKOW B, Van Weimokly SS, LYONS HA. Bilateral Central Retinal Artery Occlusion: Occurrence in a Patient with Cortisone-Treated Systemic Lupus Erythematosus, Sickle Cell Trait, and Active Pulmonary Tuberculosis. AMA archives of ophthalmology. 1955 Nov 1;54(5):670-6.
9. Toly-Ndour C, Rouquette AM, Obadia S, M’bappe P, Lionnet F, Hagege I, Boussa Khettab F, Tshilolo L, Girot R. High titers of autoantibodies in patients with sickle cell disease. J Rheumatol. 2011;38:302–309. doi: 10.3899/jrheum.100667. [PubMed][Cross Ref] [Ref list]
10. Cherner M, Isenberg D. The overlap of systemic lupus erythematosus and sickle cell disease: report of two cases and a review of the literature. Lupus. 2010 Jan 11.
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.168
