Systemic lupus erythematosus with selective IgA deficiency: A case occurred during anticonvulsive drug therapy.

概要

論文の詳細を見る
A 25-year-old male patient, with epilepsy, was admitted to our hospital because of a high fever, erythema, arthralgia and myalgia. He had been taking anticonvulsive drugs, such as diphenylhydantoin, since he had first begun having convulsive seizures twenty years ago. At the time, he had experienced convulsive seizures several times a year. Since drug-induced lupus was suspected, diphenylhydantoin was discontinued immediately. Clinical symptoms, however, did not improve three weeks after the discontinuation of diphenylhydantoin. The laboratory examination showed a low level of serum complement and a positive reaction of both anti-double stranded DNA antibody and anti-Sm antibody. These were regarded as incompatible findings for drug-induced lupus. In addition, since his mother also suffered from SLE with PSS, we suspected he had lupus diathesis. Interestingly, an immunological examination revealed a low level of serum IgA. Thus, he was finally diagnosed as a native SLE with selective IgA deficiency. After a combination of prednisolone and azathioprine was administered, the symptoms gradually improved. However, serum IgA did not return to within the normal range during hospitalization. The relationships between SLE, IgA deficiency, and the long-term administration of anticonvulsive drugs discussed.
日本臨床免疫学会の論文