Abstract
Systemic Lupus Erythematosis (SLE) is a chronic autoimmune disease of unknown cause that can affect virtually any organ of the body. Anti dsDNA antibody has been considered as a marker of renal disease. Hence elevated levels are expected in patients with Lupus Nephritis (LN). But in a subset of these patients anti dsDNA antibody is negative and this heralds the development of burned out LN (stage 5 LN) which predisposes patients to thrombosis. Prophylactic anticoagulation plays an important role in the management of such patients. We describe a case of a 19 year old female with lupus nephritis and renal vein thrombosis that had extended into the inferior vena cava. Her serology was strikingly signicant for the absence of anti dsDNA antibody. The factors that predispose to the development of venous thrombosis in patients with Lupus Nephritis are discussed. In conclusion, negative anti dsDNA antibodies heralds the development of stage ve Lupus Nephritis which predisposes to thrombosis. Guidelines for prophylactic anticoagulation as per serum albumin levels are also discussed.
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