Systemic lupus erythematosus (SLE) is an entity that promotes the formation of autoantibodies that trigger immune complexes that damage various organs of the body. Worldwide, SLE has a prevalence of 13-7000 per 100,000 people and leads to a high mortality from cardiovascular diseases, as well as the risk of developing lupus nephritis (LN) in 60% of cases. We present the case of a 41-year-old patient with a history of recently diagnosed arterial hypertension and bronchial hyperreactivity of 20 years of evolution, admitted for 1 month of evolution with asthenia, myalgia, arthralgia and fever; she identifies malar erythematous dermatosis and systolic murmur in a pulmonary focus. When presenting with proteinuria, microhematuria and renal functional impairment, positive ANAs were performed, which is why it was classified as lupus nephropathy, and she needed to start hemodialysis. In the presence of the murmur, an echocardiogram was performed, which showed a pulmonary valve with a 1cm image of vegetation, causing moderate regurgitation. With the diagnosis of Libman-Sacks endocarditis, anticoagulant treatment, steroids, and mycophenolate were started, evolving to normal renal function.
Kaposi's Sarcoma (KS) is an angioproliferative neoplasm, the causative agent is human herpes virus 8 and the second most frequent tumor after non-Hodgkin lymphoma related to the human immunodeficiency virus (VIH). We present the case of a 40-year-old male with no history of chronic diseases, who began his condition with adenopathies in the bilateral inguinal region, adding a productive cough, lymphedema, and skin lesions with nodular characteristics and bleeding ulcers. A positive HIV test was reported, and a biopsy was performed, showing evidence of a spindle cell neoplasm compatible with KS. Laboratories with hemoglobin 8.3 mg/dL, platelets 239,000/uL, leukocytes 7.29/uL, glucose 76 mg/dL, creatinine 2.2 mg/dL, urea 80 mg/dL, albumin 1.69 g/dL, TGO 18 IU/L, TGP 5 IU/L, DHL 189 IU/L, viral load 283,259 copies and CD4 192 cells. Chest and abdomen computed tomography with evidence of pleural effusion, and multiple retroperitoneal and inguinal adenopathies. Starting concomitant retroviral treatment with liposomal doxorubicin, improving clinical status and laboratory parameters. HIV-infected people are at high risk of developing KS, early initiation of antiretroviral therapy, and maintenance of high CD4 cell counts are essential to reduce the incidence.
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