The de novo diagnosis of systemic lupus erythematosus in a hemodialysis patient.

We present the first reported case of a patient who developed de novo systemic lupus erythematosus (SLE) after the initiation of dialysis for chronic renal failure. The etiology of his renal failure was secondary to biopsy-proven idiopathic membranoproliferative glomerulonephritis in conjunction with accelerated hypertension. The physical, biochemical or serologic findings of SLE did not become apparent until 4 years after the initiation of hemodialysis. This deviates from the natural history of SLE; typically, once dialysis is initiated, disease and serologic activity diminish with time to the point where therapy is no longer required. Therefore, this first diagnosis of SLE after years on dialysis represents a novel observation.