I was asked to evaluate a patients profile and make a diagnosis, and I
came across a curious question. The patient in question appears to
develop SLE (based on a false positive test for syphilis, positive
anti-nuclear/anti-DNA antibodies, persistent fever, IgM and C3 deposits at
the dermal-epidermal junction, and lymphoadenopathy). All of these
clinical symptoms appear about 4 weeks after she began using oral
contraceptive, however, the false positive for syphilis was present before
the use of this birth control. After about two months of these symptoms,
the patient was taken off oral contraceptives. At this point she then
became afebrile, and her 24 hour creatine clearance went back to normal
(up to 120 cc/min vs 50 cc/min).
I am curious as to what the role of the oral contraceptives may play
in enhancing/exacerbating what appears to be a first diagnosis of SLE? Is
the decline in fever and renormalization of creatine clearance
attributable to the contraceptive, or is it merely the coincidental
remission of the autoimmunity as often seen in SLE?
If you may have any clues or insight, please reply!
Thanks,
Crobin4881 at aol.com