Late Onset Systemic Lupus Erythematosus - A Case From a Tertiary Centre in Kerala

Abstract

Abstract Our differential diagnosis in this 76 year old female, who presented with history of anasarca, hypoproteinemia, mesenteric lymphadenopathy and low C3 rapidly progressive glomerulonephritis, placed `malignancy` in the top of the list followed by `extrapulmonary tuberculosis`. Though not impossible, it was a pleasant surprise to find the serological markers for Systemic lupus Erythematosus (SLE) turn positive. These were complemented by the renal biopsy findings, predominantly the Electron microscopy. We treated the patient according to the standard guidelines and around 4 weeks later she succumbed to infections, retrospectively considered to be from immunosuppression.  "Do we need to reduce immunosuppression in elderly patients with Systemic lupus Erythematosus?", was a seed that was sown.