Overlap syndrome in late-onset systemic lupus erythematosus with lupus nephritis and MPO-ANCA pauci-immune glomerulonephritis and tuberculosis: an uncommon association

Systemic lupus erythematosus is a systemic autoimmune pathology that generally presents in young people and manifests acutely, while its late presentation in people over 50 years of age is rare and insidious. Vasculitis is a pathology that afects any vessel producing fbrinoid necrosis, and presents with a positive antineutrophil cytoplasmic antibody. Te concomitance of these two entities is rare and leads to worse clinical outcomes. We present a 73-year-old female patient who presented with rapidly progressive glomerulonephritis requiring renal replacement therapy, pulmonary tuberculosis, late-onset lupus erythematosus with lupus nephritis, and a positive result for neutrophil cytoplasmic antibody. An immune-mediated extracapillary proliferative glomerulonephritis was found when the biopsy was performed, with obvious signs of vasculitis, an overlap syndrome was found between these entities. She was initially treated with antituberculosis therapy, boluses of methylprednisolone and continued with intermittent renal replacement therapy; however, due to the severity of his pathologies, she had a fatal outcome. Te concomitance between these autoimmune pathologies is unusual; there is a late-onset overlap syndrome between lupus nephritis accompanied by myeloperoxidase-antineutrophil cytoplasmic antibody and pauci-immune glomerulonephritis. Te dual presentation es tablishes clinical challeng.

• Autores: Dulce Muñoz, Jaime Arturo; Aroca-Martinez, Gustavo; Seni, Christian; Perea Rojas, Diana Marcela; CABARCAS BARBOSA, OMAR; Niño Hernández, Lucia Mercedes; Gaivao Arciniegas, Dario Jose; García Jarava, Camila Maria; Olivares Olmos, Marianela; Seni Hernandez, Sebastian Andre; Pérez Jiménez, Valentina; Rojas-Torres, Indiana-Luz
• Fecha de publicación: 2025
• Institución: Universidad Simón Bolívar
• Repositorio: Repositorio Digital USB
• Idioma: eng
• OAI Identifier: oai:bonga.unisimon.edu.co:20.500.12442/16340
• Acceso en línea: https://hdl.handle.net/20.500.12442/16340; https://doi.org/10.1155/crin/5285961; https://onlinelibrary.wiley.com/doi/full/10.1155/crin/5285961
• Palabra clave: ANCA; ANCA; ANCA-associated vasculitis; Antibodies; Antineutrophil cytoplasmic; Glomerulonephritis; Erythematosus; Lupus nephritis; MPO; Myeloperoxidase; Systemic; Vasculitis
• Rights: openAccess
• License: Attribution-NonCommercial-NoDerivs 3.0 United States