Systemic Lupus Erythematosus and Anti Phospholipid Syndrome in a Male Patient: A Case Report

Sawlani A, Masood R, Bai S, Anwar A
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Abstract

Abstract Systemic Lupus Erythematosus (SLE) and Antiphospholipid Syndrome (APS) are two distinct autoimmune disorders characterized by dysregulated immune responses, organ involvement, and the presence of autoantibodies in the bloodstream. Primary Antiphospholipid Syndrome (APS) can occur among individuals who are generally healthy and have no history of an underlying systemic autoimmune illness. In contrast, several other systemic autoimmune diseases, including SLE, have the potential to cause secondary Antiphospholipid Syndrome (APS). While Systemic Lupus Erythematosus (SLE) and Antiphospholipid Syndrome (APS) affect women of childbearing age, there are only a few reported case studies documenting the presence of SLE or APS individually in male patients. However, the coexistence of both conditions in a male patient is extremely rare, with only a few documented cases reports available to date. This case report presents a unique occurrence of concurrent SLE and APS in a forty-year-old male patient, highlighting the rarity of such a presentation. The patient presented with per rectal and mucosal bleeding and had been on warfarin therapy for 16 years due to a history of recurrent Deep Vein Thrombosis (DVT), but was not evaluated further. Immune-related laboratory results revealed positive antinuclear antibodies, anti-dsDNA antibodies, anticardiolipin antibodies, lupus anticoagulants, and direct Coombs test. Concurrent SLE and APS were diagnosed by meeting the classification criteria for both diseases. This report adds to the medical literature and emphasizes the significance of considering concurrent SLE and APS as a potential diagnosis in males. Further research is needed to enhance our understanding of the underlying mechanisms and the best approaches for managing this rare coexistence.
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一名男性患者的系统性红斑狼疮和抗磷脂综合征:病例报告
摘要 系统性红斑狼疮(SLE)和抗磷脂综合征(APS)是两种不同的自身免疫性疾病,其特点是免疫反应失调、器官受累以及血液中存在自身抗体。原发性抗磷脂综合征(APS)可发生于一般健康、无潜在系统性自身免疫疾病史的人。相比之下,包括系统性红斑狼疮在内的其他几种系统性自身免疫疾病则有可能导致继发性抗磷脂综合征(APS)。虽然系统性红斑狼疮(SLE)和抗磷脂综合征(APS)会影响育龄妇女,但只有少数病例研究记录了男性患者单独患有系统性红斑狼疮或抗磷脂综合征。然而,男性患者同时患有这两种疾病的情况却极为罕见,迄今只有少数病例报告。本病例报告介绍了一名四十岁男性患者并发系统性红斑狼疮和 APS 的独特病例,凸显了这种病症的罕见性。该患者出现直肠周围和粘膜出血,由于有复发性深静脉血栓(DVT)病史,已使用华法林治疗 16 年,但未接受进一步评估。免疫相关实验室结果显示,抗核抗体、抗dsDNA抗体、抗心磷脂抗体、狼疮抗凝物和直接库姆斯试验均呈阳性。根据两种疾病的分类标准,该患者被诊断为并发系统性红斑狼疮和 APS。本报告为医学文献增添了新的内容,强调了将并发系统性红斑狼疮和 APS 作为男性潜在诊断的重要性。我们需要进一步开展研究,以加深对这一罕见并发症的潜在机制和最佳治疗方法的了解。
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