Jamal Eddine NAJI, Hicham RAFIK, Mohamed Reda ELFAROUKI, Imane ELABOUDY, Mohamed HASSANI
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 2
Issue: 2
Date of Publication: 2025/02/08
Introduction : Paclitaxel is a pharmaceutical molecule belonging to the taxane family of antimitotic agents, which act by blocking the disassembly of microtubules. Among the rare side effects of this chemotherapy is induced lupus, responsible for the generation of autoantibodies and a clinical presentation less severe than that of systemic lupus erythematosus.
Observation : We report the case of a 69-year-old patient treated 20 years ago for pulmonary tuberculosis and bilateral bronchial adenocarcinoma treated with neoadjuvant Paclitaxel and Carboplatin-based chemotherapy. She was admitted following the discovery of advanced renal failure 6 months after her 3rd course of treatment for glomerular nephropathy syndrome. A renal biopsy showed class IV (A/C) lupus proliferative glomerulonephritis. Immunological tests (AAN, native DNA, Sm, SSa, SSb) were negative, and the C3 fraction of complement was consumed. This suggests systemic lupus with renal tropism and secondary Gougerot Sjögren's syndrome. Treatment consisted of induction therapy with corticoids and Cyclophosphamide. Progression was favourable with Rituximab-based maintenance therapy.
Discussion: The pathophysiological mechanisms of induced lupus are not clearly defined, and many predisposing factors are known. Therapeutic management is essentially based on recognition and discontinuation of the incriminating molecule.
Conclusion: Renal involvement is exceptional in induced lupus. Several predisposing factors are known, mainly genetic. Therapeutic management is that of systemic lupus erythematosus.
Paclitaxel, Lupus, Glomerulonephritis
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