© 2002 by Annals of the Rheumatic Diseases
LETTER
Lupus relapse after prostaglandin E1 administration: activation of a cytokine cascade?
1 Nephrology and Services, Complejo Hospitalario Ciudad Real, Spain
2 Immunology Service, Complejo Hospitalario Ciudad Real, Spain
Correspondence to:
Correspondence to:
Dr M de la Torre, Servicio de Nefrología, Complejo Hospitalario de Ciudad Real, 13002 Ciudad Real, Spain;
mtorref@nexo.es
Keywords: prostaglandin E1; cytokine cascade; systemic lupus erythematosus
A variety of abnormalities in cytokine production occur in human and murine lupus, but their specific role in lupus pathogenesis is unknown.1 Recent in vitro studies emphasise the role of prostaglandins in the cytokine induction and modulation of the humoral immune response.2,3 We present a patient with systemic lupus erythematosus (SLE) who had a relapse after prostaglandin E1 (PGE1) administration, which to our knowledge has not been previously reported.
A 25 year old woman was admitted to hospital to receive treatment with IV PGE1 owing to severe Raynaud's phenomenon. Fifteen years previously SLE had been diagnosed according to American Rheumatism Association (ARA) criteria, with renal biopsy proven diffuse proliferative lupus glomerulonephritis (WHO class IV). A physical examination showed only painful, violaceous, and atrophic finger pads with no signs of systemic inflammatory disease. The chest x ray films were normal and laboratory investigations showed antinuclear antibodies (ANA; titre 1/160) and
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