Sun-induced life-threatening lupus nephritis.

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Schmidt E, Tony HP, Brocker EB, Kneitz C

Sun-induced life-threatening lupus nephritis.

Ann N Y Acad Sci. 2007 Jun;1108:35-40.

PubMed ID

17893968 [ View in PubMed

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Abstract

Photosensitivity is a widely known characteristic of both cutaneous and systemic lupus erythematosus (LE). However, sun-induced organ involvement is rarely reported in LE. We describe a 34-year-old woman who had been in complete remission of systemic LE for more than 8 years without treatment. After sunbathing, she developed acute sunburn followed by cutaneous LE in sun-exposed areas. Six weeks later, a lupus nephritis was diagnosed and high serum levels of antidouble-stranded (ds) DNA and anti-Ro/SSA antibodies were detected. Treatment with systemic cyclophosphamide and prednisolone led to septicemia requiring assisted ventilation for more than 2 weeks and repeated hemodialysis. Clinical remission was achieved 3 months later by the use of prednisolone and mycophenolate mofetile. Meanwhile, mild proteinuria persisted, anti-dsDNA antibodies normalized. We hypothesize that the sunburn-induced keratinocyte necrosis/apoptosis exposed intracellular antigens as trigger for the generation of autoantibodies that finally mediated immune-complex nephritis. The patient highlights the impact of UV light not only on skin but also on internal organ involvement in LE.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Cyclophosphamide	DNA	Nucleotide	Humans	Yes	Cross-linking/alkylation	Details