Renal cortical necrosis at presentation in a patient with systemic lupus erythematosus: An autopsy case report

Abstract

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disorder. Renal involvement has the worst prognosis. However, renal cortical necrosis is extremely unusual in SLE. In this case report, we describe the autopsy findings in a young female patient with SLE presenting with renal failure. At autopsy, there was Libmann-Sacks endocarditis with multiorgan infarcts and renal cortical necrosis. Secondary antiphospholipid antibodies contribute to the cardiac and renal manifestations in SLE. We discuss the incidence and pathogenesis of endocarditis with differential diagnosis for cortical necrosis in a patient of SLE. been reported to have the worst outcome [1]. In most of the cases with mortality, association of antiphospholipid antibody has been noted [2]. We report a young female patient who presented with complicated lupus with the characteristic histopathologic features on autopsy. © Clinical Rheumatology 2010.