Pure lupus podocytopathy first presenting as thrombotic thrombocytopenic purpura-like syndrome

Guillermo Delgado-García, Carlos Cámara-Lemarroy, Adrián Infante-Valenzuela, Perla Colunga-Pedraza, Gabriela Alarcón-Galván, Arian Armenta-González, Héctor Jorge Villarreal-Velázquez

Research output: Contribution to journalLiterature review

Abstract

© 2015, International League of Associations for Rheumatology (ILAR). Lupus podocytopathy (LP) is an uncommon proteinuric disorder in the spectrum of lupus nephropathy. Its histological features are similar to those described in minimal change disease (MCD) with or without mesangial immune deposits. Although infrequent, a close relationship between systemic lupus erythematosus (SLE) and thrombotic thrombocytopenic purpura (TTP) is well accepted. Proteinuria in the setting of SLE has previously been associated with the development of TTP-like syndrome. As far as we know, LP first presenting as a TTP-like syndrome has never been reported. Here, we describe the case of a previously healthy 45-year-old woman who developed simultaneously these two conditions and then we briefly review the literature on the topic, emphasizing the previous cases of concurrent initial diagnosis of both SLE and MCD (n = 7) and SLE and TTP (n = 72). In conclusion, renal biopsy is central to the management of SLE patients with nephrotic syndrome. Furthermore, in a SLE patient with anemia and thrombocytopenia, TTP should be part of the differential diagnosis, even when no schistocytes were detected in peripheral blood smear.
Original languageEnglish
Pages (from-to)2131-2136
Number of pages6
JournalClinical Rheumatology
DOIs
Publication statusPublished - 1 Aug 2016
Externally publishedYes

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Thrombotic Thrombocytopenic Purpura
Systemic Lupus Erythematosus
Lipoid Nephrosis
Nephrotic Syndrome
Rheumatology
Proteinuria
Thrombocytopenia
Anemia
Differential Diagnosis
Kidney
Biopsy

All Science Journal Classification (ASJC) codes

  • Rheumatology

Cite this

Delgado-García, G., Cámara-Lemarroy, C., Infante-Valenzuela, A., Colunga-Pedraza, P., Alarcón-Galván, G., Armenta-González, A., & Villarreal-Velázquez, H. J. (2016). Pure lupus podocytopathy first presenting as thrombotic thrombocytopenic purpura-like syndrome. Clinical Rheumatology, 2131-2136. https://doi.org/10.1007/s10067-015-3069-9
Delgado-García, Guillermo ; Cámara-Lemarroy, Carlos ; Infante-Valenzuela, Adrián ; Colunga-Pedraza, Perla ; Alarcón-Galván, Gabriela ; Armenta-González, Arian ; Villarreal-Velázquez, Héctor Jorge. / Pure lupus podocytopathy first presenting as thrombotic thrombocytopenic purpura-like syndrome. In: Clinical Rheumatology. 2016 ; pp. 2131-2136.
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abstract = "{\circledC} 2015, International League of Associations for Rheumatology (ILAR). Lupus podocytopathy (LP) is an uncommon proteinuric disorder in the spectrum of lupus nephropathy. Its histological features are similar to those described in minimal change disease (MCD) with or without mesangial immune deposits. Although infrequent, a close relationship between systemic lupus erythematosus (SLE) and thrombotic thrombocytopenic purpura (TTP) is well accepted. Proteinuria in the setting of SLE has previously been associated with the development of TTP-like syndrome. As far as we know, LP first presenting as a TTP-like syndrome has never been reported. Here, we describe the case of a previously healthy 45-year-old woman who developed simultaneously these two conditions and then we briefly review the literature on the topic, emphasizing the previous cases of concurrent initial diagnosis of both SLE and MCD (n = 7) and SLE and TTP (n = 72). In conclusion, renal biopsy is central to the management of SLE patients with nephrotic syndrome. Furthermore, in a SLE patient with anemia and thrombocytopenia, TTP should be part of the differential diagnosis, even when no schistocytes were detected in peripheral blood smear.",
author = "Guillermo Delgado-Garc{\'i}a and Carlos C{\'a}mara-Lemarroy and Adri{\'a}n Infante-Valenzuela and Perla Colunga-Pedraza and Gabriela Alarc{\'o}n-Galv{\'a}n and Arian Armenta-Gonz{\'a}lez and Villarreal-Vel{\'a}zquez, {H{\'e}ctor Jorge}",
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Delgado-García, G, Cámara-Lemarroy, C, Infante-Valenzuela, A, Colunga-Pedraza, P, Alarcón-Galván, G, Armenta-González, A & Villarreal-Velázquez, HJ 2016, 'Pure lupus podocytopathy first presenting as thrombotic thrombocytopenic purpura-like syndrome', Clinical Rheumatology, pp. 2131-2136. https://doi.org/10.1007/s10067-015-3069-9

Pure lupus podocytopathy first presenting as thrombotic thrombocytopenic purpura-like syndrome. / Delgado-García, Guillermo; Cámara-Lemarroy, Carlos; Infante-Valenzuela, Adrián; Colunga-Pedraza, Perla; Alarcón-Galván, Gabriela; Armenta-González, Arian; Villarreal-Velázquez, Héctor Jorge.

In: Clinical Rheumatology, 01.08.2016, p. 2131-2136.

Research output: Contribution to journalLiterature review

TY - JOUR

T1 - Pure lupus podocytopathy first presenting as thrombotic thrombocytopenic purpura-like syndrome

AU - Delgado-García, Guillermo

AU - Cámara-Lemarroy, Carlos

AU - Infante-Valenzuela, Adrián

AU - Colunga-Pedraza, Perla

AU - Alarcón-Galván, Gabriela

AU - Armenta-González, Arian

AU - Villarreal-Velázquez, Héctor Jorge

PY - 2016/8/1

Y1 - 2016/8/1

N2 - © 2015, International League of Associations for Rheumatology (ILAR). Lupus podocytopathy (LP) is an uncommon proteinuric disorder in the spectrum of lupus nephropathy. Its histological features are similar to those described in minimal change disease (MCD) with or without mesangial immune deposits. Although infrequent, a close relationship between systemic lupus erythematosus (SLE) and thrombotic thrombocytopenic purpura (TTP) is well accepted. Proteinuria in the setting of SLE has previously been associated with the development of TTP-like syndrome. As far as we know, LP first presenting as a TTP-like syndrome has never been reported. Here, we describe the case of a previously healthy 45-year-old woman who developed simultaneously these two conditions and then we briefly review the literature on the topic, emphasizing the previous cases of concurrent initial diagnosis of both SLE and MCD (n = 7) and SLE and TTP (n = 72). In conclusion, renal biopsy is central to the management of SLE patients with nephrotic syndrome. Furthermore, in a SLE patient with anemia and thrombocytopenia, TTP should be part of the differential diagnosis, even when no schistocytes were detected in peripheral blood smear.

AB - © 2015, International League of Associations for Rheumatology (ILAR). Lupus podocytopathy (LP) is an uncommon proteinuric disorder in the spectrum of lupus nephropathy. Its histological features are similar to those described in minimal change disease (MCD) with or without mesangial immune deposits. Although infrequent, a close relationship between systemic lupus erythematosus (SLE) and thrombotic thrombocytopenic purpura (TTP) is well accepted. Proteinuria in the setting of SLE has previously been associated with the development of TTP-like syndrome. As far as we know, LP first presenting as a TTP-like syndrome has never been reported. Here, we describe the case of a previously healthy 45-year-old woman who developed simultaneously these two conditions and then we briefly review the literature on the topic, emphasizing the previous cases of concurrent initial diagnosis of both SLE and MCD (n = 7) and SLE and TTP (n = 72). In conclusion, renal biopsy is central to the management of SLE patients with nephrotic syndrome. Furthermore, in a SLE patient with anemia and thrombocytopenia, TTP should be part of the differential diagnosis, even when no schistocytes were detected in peripheral blood smear.

U2 - 10.1007/s10067-015-3069-9

DO - 10.1007/s10067-015-3069-9

M3 - Literature review

SP - 2131

EP - 2136

JO - Clinical Rheumatology

JF - Clinical Rheumatology

SN - 0770-3198

ER -

Delgado-García G, Cámara-Lemarroy C, Infante-Valenzuela A, Colunga-Pedraza P, Alarcón-Galván G, Armenta-González A et al. Pure lupus podocytopathy first presenting as thrombotic thrombocytopenic purpura-like syndrome. Clinical Rheumatology. 2016 Aug 1;2131-2136. https://doi.org/10.1007/s10067-015-3069-9