"Lupus And Anti-Dsdna: Does Anti-Dsdna Level Correlate With Disease Activity? – A Case Report."

Abstract

Background: Systemic lupus erythematosus is a chronic autoimmune disease that mostly affects women. Approximately 50% of lupus patients experience lupus nephritis. In about 2% of cases, immune thrombocytopenia can develop into systemic lupus. High anti-dsDNA levels and low complement levels often mark disease activity. Anti-dsDNA levels are important in disease pathogenesis and correlate with disease activity. We are reporting a case of anti-dsDNA-negative lupus nephritis. Case report: A 26-year-old female presented with complaints of bilateral lower limb swelling and facial puffiness for a month. She was evaluated for thrombocytopenia around 6 months back and was labeled as a case of Immune thrombocytopenia she was not on any steroid therapy at the time of presentation with us. She was evaluated for the current complaints and a provisional diagnosis of nephrotic syndrome with suspicion of lupus nephritis as the primary pathology was made. Renal biopsy was done after building up her platelets and her biopsy revealed stage 5 lupus nephritis. However, her immunological profile showed a negative anti-dsDNA. She was started on mycophenolate mofetil (MMF) along with steroids, hydroxychloroquine, and Tacrolimus. Following drug therapy there was a significant reduction in proteinuria and remission was achieved. Conclusion: Anti-dsDNA titers are strongly associated with systemic lupus erythematosus disease activity, particularly in lupus nephritis. Managing lupus nephritis typically involves immunosuppressive medications, which can have adverse effects on reproductive health. Our case report examines the role of anti-dsDNA titers in lupus and guides in managing lupus nephritis in women of reproductive age.