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NDT Advance Access originally published online on March 26, 2009
Nephrology Dialysis Transplantation 2009 24(6):1997-1999; doi:10.1093/ndt/gfp128
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Drug-induced lupus and antiphospholipid syndrome associated with cysteamine therapy

Leah Krischock1, Catherine Horsfield2, David D’Cruz3 and Susan P. A. Rigden1

1 Department of Paediatric Nephrology, Evelina Children's Hospital, St Thomas’ Hospital 2 Department of Pathology, St Thomas’ Hospital 3 Louise Coote Lupus Unit, St Thomas’ Hospital, Westminster Bridge Road, London, UK

Correspondence and offprint requests to: Leah Krischock; E-mail: lkrischock{at}talktalk.net



  Abstract

Serological evidence of drug-induced lupus (DIL) and antiphospholipid syndrome (APS) were detected in a paediatric patient with nephropathic cystinosis during work-up for live related renal transplantation. Cysteamine was considered the most likely cause. Antinuclear (ANA) and antihistone antibodies disappeared after stopping cysteamine. ANA became positive after reintroduction of cysteamine. The patient's post-transplant course was complicated by severe thrombosis, with histological findings in her native nephrectomy consistent with APS. This is the first reported case of DIL and APS secondary to cysteamine therapy. Clinicians should exclude autoimmune abnormalities in patients with cystinosis, especially if patients report non-specific, unusual or unexplained symptoms.

Keywords: cysteamine; drug-induced lupus; antiphospholipid syndrome; nephropathic cystinosis

Received for publication: 2. 3.09
Accepted in revised form: 3. 3.09


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