Urticaria, angioneurotic oedema and Sjogren's syndrome: unusual features of systematic lupus erythematosus-a case report

Abstract

Urticaria, Sjogren's syndrome and angioneurotic oedema are rare features of systemic lupus erythematosus (SLE). These are not frequently encountered in SLE as prominent presenting features although these could be seen. It is known that patients with associated renal or central nervous system involvements are not associated with an decreased chance of survival five yedar4s after diagnosis. We report a case of SLE who had rare features with renal involvement. The case report is on a middle aged woman who has had on and off urticaria for ten years prior to presentation, but in the last two years before presentation, it became worse and more persistent. It could no longer be helped by any medication. She was then referred to our hospital where she was seen and investigated for connective tissue disease. She was found to have some features suggestive of SLE. While being investigated, she showed features of both Sjogren's syndrome and angioneurotic oedema. The angioneurotic oedema subsided completely with antihistamine (chlorpheniramine maleate) while the SLE also got better on steroids (prednisolone). Her voice which used to diminish as speech progressed also got better. She, however, developed marked fluid and electrolyte imbalance at her home, which was very far from our hospital. This abnormality was not corrected at the peripheral hospital that attended to her before she reached our hospital. By the time she was attended to in our hospital, she was oliguric and this rapidly progressed to anuria and she died.

Highland Medical Research Journal Vol. 4(1) 2006: 123-129