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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 344:1152-1158 April 12, 2001 Number 15
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Case 11-2001— Rapidly Progressive Renal Failure in a 35-Year-Old Woman with Systemic Lupus Erythematosus
Cecil H. Coggins, and Robert T. McCluskey

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Presentation of Case

A 35-year-old woman was admitted to the hospital because of rapidly worsening renal failure.

Twelve years before admission, she had received a diagnosis of systemic lupus erythematosus, manifested by Raynaud's syndrome, thoracic and abdominal serositis, rash, and livedo reticularis. Two years later, the antiphospholipid-antibody syndrome was diagnosed; she had a miscarriage, a postpartum pulmonary embolus, ulcers on the fingertips, thrombocytopenia, and abnormal results on liver-function tests. More recently, she had had two successful pregnancies. Warfarin had been prescribed but was discontinued four months before admission because of inadequate compliance with blood testing, and daily aspirin was substituted. She also took . . . [Full Text of this Article]

Differential Diagnosis

Diagnosis of Systemic Lupus Erythematosus

Diagnosis of the Antiphospholipid-Antibody Syndrome

Cause of the Current Illness

Cause of Renal Failure

Conclusions

Clinical Diagnoses

Dr. Cecil H. Coggins's Diagnoses

Pathological Discussion

Thrombotic Microangiopathy

Systemic Lupus Erythematosus

Therapy and Outcome

Anatomical Diagnoses

References


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