Sumiishi A
Japan
Case Report
The Appearance of In vivo ANA Positivity after a Period of 17 years in a Patient with Lupus Nephritis who had Received both Methylprednisolone and Cyclophosphamide Pulse Therapy
Author(s): Nakabayashi K, Fukuoka K, Sumiishi A, Sano K, Nose M, Yan K, Kudo A, Matsubara S and Arimura YNakabayashi K, Fukuoka K, Sumiishi A, Sano K, Nose M, Yan K, Kudo A, Matsubara S and Arimura Y
In vivo anti-nuclear antibody positive phenomenon in the renal tissues except for necropsy/autopsy cases or very severe cases of systemic lupus erythematosus is a controversial issue until today. However, we experienced a case of lupus nephritis that showed in vivo anti-nuclear antibody-positive cells in the renal tissues. Four successive renal biopsies over 17 years were studied with immunofluorescence as well as immunohistochemical and immuneelectron microscopic staining. The first, second and third biopsies did not reveal any in vivo anti-nuclear antibodypositive cells. However, the fourth biopsy in relapse showed positive cells, and the transfer of the patient’s serum into the mice provoked in vivo anti-nuclear antibody-positive cells in the mouse intestines. We present this case in detail and discuss the implications of these observations.
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