Systemic lupus erythematosus and diabetic mellitus is it single or two entity(es)
- Ni Made Mindawati ,
- Ketut Dewi Kumara Wati ,
- I Made Arimbawa ,
- Ida Bagus Ramajaya Sutawan ,
- I Made Darma Yuda ,
Introduction: Systemic lupus erythematosus (SLE) is a complex and chronic autoimmune disease with varied clinical manifestations and multi-organ involvement. The disease may present with acute, severe, and life-threatening symptoms or present as a fluctuating and chronic process that impacts several systems and increases the risk of malignancy. Systemic lupus erythematosus (SLE) often coexists with other diseases. Diabetes mellitus (DM) is an example and patients with SLE-DM can present with clinical features common to both disorders. Type 2 diabetes (T2D) is characterized by insulin resistance the inability of tissues to respond to insulin, and a progressive pancreatic beta cell dysfunction in response to glucose levels. The disease is thought to be caused by environmental and inherited factors in about equal proportions. Many environmental risk factors are known, including obesity, sedentary lifestyle, stress, nutritional factors and toxins. The report aims to describe Systemic Lupus Erythematosus and Diabetes mellitus as single or two entity(es).
Case presentation: A 14-year-old female patient who was admitted to the hospital with complaints of weakness and drowsiness was getting worse 3 days before admitted from hospital. There have been complaints of fatigue for last 3 years accompanied by a lot of eating and drinking and urinating. Complaints of pain in both joints of the hands and both knees appeared in the last 3 months and had been getting worse. Hair loss existed in the past 4 months before being admitted to the hospital. Blurred vision in the right eye in the last 6 months has worsened in the last 1 month. Vision loss in the last 3 months. Body weight was reduced 4 kilograms within 3 months without any loss of appetite. Initial laboratory results revealed hyperglycemia, antinuclear antibodies (ANA) IF 1:100 and ANA Profile Sm (+), dyslipidemia, increase of creatinine serum with glomerular filtration rate 72.41 m2/BSA (decreased 38%). Other examinations showed that C-peptide is normal and beta islet antibody is negative. Echocardiography resulted tricuspid regurgitation with normal ventricle function.
Conclusion: Systemic Lupus Erythematosus and Diabetes mellitus is a rare condition that warrants a thorough evaluation to both determine the diagnosis and predict the clinical course of disease.