Glomerulonephritis and Coombs-positive hemolytic anemia mimicking scleroderma renal crisis in an overlap of systemic lupus erythematosus and diffuse systemic sclerosis

Rheumatol Int. 2020 May;40(5):785-789. doi: 10.1007/s00296-019-04471-w. Epub 2019 Nov 7.

Abstract

Systemic sclerosis (SSc) may overlap frequently with other rheumatic diseases, including systemic lupus erythematosus (SLE), which can require high-dose steroids depending on the clinical presentation. We present a case involving this overlap in which the patient concomitantly developed lupus nephritis and Coombs (+) hemolytic anemia, which was confused with scleroderma renal crisis. In this condition, assessing for lupus nephritis with timely renal biopsy and lupus serology can aid in guiding the appropriate treatment. We discuss the clinical features and challenging management of this case with a review of the English-language literature for SSc and SLE overlap with glomerulonephritis.

Keywords: Glomerulonephritis; Hemolytic anemia; Scleroderma renal crisis; Systemic sclerosis and systemic lupus erythematosus overlap.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Hemolytic / complications
  • Anemia, Hemolytic / diagnosis*
  • Diagnosis, Differential
  • Female
  • Glomerulonephritis / complications
  • Glomerulonephritis / diagnosis*
  • Humans
  • Lupus Nephritis / diagnosis
  • Scleroderma, Localized / diagnosis