Systemic lupus erythematosus, lupus nephritis, and renal cancer in a rare association: A study of an early cohort in Cuba with the presentation of a case
Keywords:
systemic lupus erythematosus, lupus nephropathy, cancer, nephrectomyAbstract
Systemic lupus erythematosus is a complex chronic autoimmune-rheumatic disorder that affects multiple organs and systems with varying degrees of severity. It is characterized by unpredictable flares of activity that progress to irreversible organ damage, frequently causing lupus nephropathy. SLE has been associated with several comorbid conditions such as malignant neoplasms, although its relationship with renal carcinoma in particular has been under-reported and understudied. Case reports exist in the literature, including renal cancer and nephrotic syndrome demonstrated by histology and electron microscopy. The diagnostic complexity in cases with these conditions and the therapeutic effectiveness achieved through surgery with nephrectomy, as well as the importance of a multidisciplinary approach, have been highlighted.
SLE causes elevated autoantibody production, complement activation, and the deposition of circulating immune complexes (CICs), which cause damage at various levels, particularly in the kidneys, leading to kidney damage and failure. Immunosuppressants, as part of induction therapy, can prevent damage and complications, offering a favorable prognosis; however, paradoxically, exposure to these drugs increases the risk of morbidity and the possibility of cancer by two to five times. A higher incidence of certain types of cancer, such as thyroid, neck, lymphomas, and renal carcinoma, has been observed in patients treated with immunosuppressive drugs for various autoimmune conditions, including SLE. We conducted a pilot study in an emerging cohort of patients with autoimmune-rheumatic conditions treated at the CIMEQ (Center for Disease Control and Prevention). We observed one patient with a rare association between autoimmunity, the kidney target organ, and associated cancer.
In this patient, the clinical and immunohumoral manifestations she presented confirmed the initial diagnostic suspicion of systemic lupus and nephropathy based on the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology criteria (11) after the biopsy. Similarly, 10 years later, surgery and nephrectomy were required to confirm renal carcinoma. We present this rare and interesting clinical case of a patient with the diagnosis, progression, and treatment of cancer associated with SLE, nested within an emerging cohort of cases studied at the CIMEQ (Center for Disease Control and Prevention) in Cuba
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Copyright (c) 2025 Gil Alberto Reyes Llerena, Gil Reyes Guibert , Carlos G Gutiérrez Gutiérrez, Denis Carrillo Lovet, Reynaldo J Galvizu Sánchez , Leyla Otaño Albuerne, Marlene Gibert Toledano
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