cancers and lupus : three clinical cases reported

Introduction

The association cancer and lupus is rarely found despite the risks stated. This binomial would be induced largely, but not exclusively, by immunosuppressive therapies. 

Materials and methods

Review the situations of cancer and lupus associations in hospital practice in a department of internal medicine over a period of 5 years.  

Case N ° 1

succession of Kikuchi’s disease and Hodgkin’s lymphoma in a young 28- year- old patient with a non-severe form of lupus disease (diagnosed 4 years earlier according to ACR criteria) and therefore not subject to a immunosuppressive therapy. We will note a good evolution of cancer (2 years of follow-up) and a prolonged remission of his lupus disease.    

Case N° 2 

woman, 56 years old, lupus disease discovered at the age of 40 , in its severe hematological form having benefited from immunosuppressive treatment ( cyclophosphamide and azathioprine ) and who, 7 years after this therapy, develops an angio-immunoblastic lymphoma, including l evolution, on the occasion of a macrophagic activation syndrome is fatal.    

Case N° 3 

concomitant discovery in a 41- year-old woman of an invasive breast carcinoma and a lupus nephropathy stage 2 of the WHO having benefited from a treatment based on corticoids and antimalarials of synthesis. The favorable evolution at 2 years of follow – up on the carcinological level (surgery, chemotherapy) and lupus disease is considered stable both on the nephrological level (residual proteinuria of 135mg / 24h) and systemic.  

Conclusion 

The combination of cancer and lupus is not inevitable. 

The management of one of the conditions must take into account the other in order to optimize healing and minimize accelerated atherosclerosis.