Acquired Refractory Angioneurotic Edema in a Known Case of Systemic Lupus Erythematosus

Abstract

A woman came to the emergency room with swelling of the face, which included swelling around the lips and the eyes. The patient had undergone root canal treatment under lidocaine anesthesia one day prior, after which she developed swelling. Because angioneurotic edema was a possibility, the complement components C3 and C4 and C1 esterase inhibitor (C1-INH) were tested. The C4 level was found to be very low (0.08 gm/l) and the C1 level was also on the lower side (0.26 gm/l). Angioneurotic edema with acquired C1-INH deficiency was diagnosed after complete systemic and physical examinations. The patient made a complete recovery with the help of steroids, fresh frozen plasma, antibiotics, and antiallergic medications. For its rarity, this case of systemic lupus erythematosus refractory angioneurotic edema with acquired C1-INH deficiency is being reported.

Overlap of Scleroderma and Class V Lupus Nephritis: A Rare Autoimmune Confluence

“…An inflammatory response occurs in lupus nephritis, which triggers the complement system. Lupus nephritis is a hypersensitivity reaction (type 3) that causes immunological complex deposition on the glomerular basement membrane due to anti-dsDNA attachment to DNA, forming an anti-dsDNA [3,4]. Overlap syndrome typically happens in those with ribonucleoprotein antibody (RNP AB), but co-existence with the membranous Class V lupus nephritis variant is rare, and the pathophysiology is poorly understood [5].…”