A case of systemic lupus erythematosus after taking oral contraceptives
Kawai, T.; Katoh, K.; Matsunaga, K.; Tani, K.; Okubo, T.
Nihon Naika Gakkai Zasshi. Journal of the Japanese Society of Internal Medicine 78(5): 710-711
1989
ISSN/ISBN: 0021-5384 PMID: 2768993 DOI: 10.2169/naika.78.710Document Number: 375180
In December, 1986, a 29 year old woman developed nephrosis due to systemic lupus erythematosus after taking oral contraceptives (OC) for 6.5 years. Hospitalized for 3 months, she received steroid treatment, which lowered albumin in urine. At the time of hospitalization, the following symptoms were noted. Edema on all her limbs, 4.5 g/dl of urine albumin per day, white blood cell count of 2600/mm, 640 time positive anti-nuclear antibodies, pseudo-positive response to syphilis via bentonite flocculation on particle (BFP). OC she had taken since 1980 were 0.5 mg of norgestrel day and 0/05 mg of ethinyl estradiol day. She had been routinely checked on her kidney function biannually and everything had been normal till then. For 2 months starting in December, 1987, at the patient's request, progesterone along (dydrogesterone 10 mg/day) was administered for contraception. No urine albumin was detected. It appears that autoimmune-type thyroid gland abnormality preceded systemic lupus erythematosus (SLE) which was triggered by the oral contraceptive use. Estrogen metabolism of SLE patients is characterized by estrogen active 16 alpha hydroxyestrone.