Systemic lupus erythematosus with negative antinuclear antibodies and hemolytic anemia

Abstract

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease, with exacerbations and remissions or perennial activity wich in time develops organ damage. Because of the multiple forms of presentation and the variety of organs that may be involved, the diagnosis of SLE has always been a challenge. We present the case of a patient with lupus in whom the main manifestation of the disease was hematologic, and antinuclear antibodies (ANA) were negative. ANA have been used as markers of SLE and are part of the classification criteria proposed by the American College of Rheumatology (ACR) for the diagnosis of the disease. There is, however, controversy over whether some patients who met ACR criteria, but had negative ANAs, can be labeled as SLE. There are few case reports in this regard