Lupus nephritis in a transgender woman on cross-sex hormone therapy: a case for the role of oestrogen in systemic lupus erythematosus

Lupus. 2020 Nov;29(13):1807-1810. doi: 10.1177/0961203320946372. Epub 2020 Jul 30.

Abstract

We present the case of a 22-year-old African American transgender women (male to female), who was admitted for fatigue, abdominal pain and lower extremity edema and was diagnosed with systemic lupus erythematosus (SLE) and lupus nephritis. Treatment with high-dose steroids and mycophenolate mofetil helped resolve her symptoms. She has remained off oestrogen therapy since admission and has not experienced any major complications. It is important to consider therapy outcomes in this specific patient population. A review of four other cases of transgender women on cross-sex hormone therapy who were diagnosed with lupus is also presented.

Keywords: Systemic lupus erythematosus; estrogen; nephritis; renal lupus; transgender.

Publication types

  • Case Reports

MeSH terms

  • Drug Therapy, Combination
  • Estrogens / pharmacology*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lupus Nephritis / chemically induced*
  • Lupus Nephritis / drug therapy
  • Male
  • Mycophenolic Acid / therapeutic use
  • Steroids / therapeutic use
  • Transgender Persons*
  • Young Adult

Substances

  • Estrogens
  • Immunosuppressive Agents
  • Steroids
  • Mycophenolic Acid