Abstract

Systemic Lupus Erythematosus (SLE) is an Auto immune disease and multigenic disease in which organs and cells undergo damage mediated by tissue-binding autoantibodies and immune complexes. [1] 90% of patients are women of child bearing years.  Prevalence of SLE is 4250/100,000 have been reported with female predominance varying from 4:1 before puberty to 8:1 after puberty. Most common clinical manifestations are systemic (95%): fatigue, fever, malaise, weight loss and musculoskeletal features (95%) and cutaneous manifestations - photosensitivity and rash (70 - 80%) and less common clinical manifestations are renal (30 - 40%), occular (15%), Thrombosis (15%). The diagnosis of SLE is typically based on the revised (1997) criteria of American College of Rheumatic Association (ACR). [2] Anti dsDNA antibodies are highly specific for SLE but they are present only in 70% of cases. [3] Manson et al. found high avidity anti dsDNA antibodies in only 13 out of their 16 patients and recommended antinucleosome antibodies to further increase diagnostic specificity. [4] Min et al. in a prospective study of 129 patients with SLE found little or no anti dsDNA reactivity in 25 cases during the course of their disease.  Among these antinucleosome antibodies were present in 15 patients, 8 patients with anti dsDNA negative SLE had renal disease and all these cases had antinucleosome antibodies.[5]  We report a rare case of Renal involvement in SLE with absence of rash.