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Dengue fever triggering systemic lupus erythematosus and lupus nephritis: a case report

Authors Talib SH, Bhattu SR, Bhattu R, Deshpande SG, Dhiphale DB

Received 29 June 2013

Accepted for publication 21 August 2013

Published 31 October 2013 Volume 2013:6 Pages 71—75


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

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SH Talib, SR Bhattu, R Bhattu, SG Deshpande, DB Dahiphale

Department of Medicine and Nephrology, MGM Medical College and Hospital, Aurangabad, Maharashtra, India

Abstract: We report a rare case of dengue fever triggering systemic lupus erythematosus and lupus nephritis. The patient presented herself during a large outbreak of dengue fever in December 2012 in Maharashtra, India. The diagnosis of dengue fever was confirmed by the presence of NS-1 antigen during the first few days of febrile illness. Eight weeks later, kidney tissue biopsy studies revealed evidence of lupus nephritis on microscopic examination and immunofluorescence. The report interpreted it as focal proliferative glomerulonephritis and segmental sclerosis (Stage IIIC). The case was also found positive for perinuclear antineutrophil cytoplasmic antibodies by indirect immunofluorescence assay. An active and effective management of a case essentially calls for clear perception of differentiating dengue-induced lupus flare, antineutrophil cytoplasmic antibody-related nephropathy, and/or dengue-induced de-novo lupus disease. Dengue viremia may be the trigger for immune complex formation in patients who are predisposed to developing autoimmune diseases. The present case explains the importance of considering the diagnosis of dengue-related lupus nephritis as an atypical occurrence in appropriate situations, as in this case. It would not be improper to regard this escalating disease as an expanded feature of dengue.

Keywords: kidney biopsy, glomerulonephritis, segmental sclerosis, lupus flare, dengue viremia, autoimmune, de-novo lupus nephritis

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