A case of systemic lupus erythematosus responding to diet therapy

A 16-year-old girl complained of fever, facial erythema and stomatitis, and was admitted to our hospital in June, 1980. The girl, having the onset of epileptic attacks at the age of 12 years, had been treated for 3 years with anticonvulsants. She stopped the drug intake about 6 months before the hospitalization. Laboratory data on admission revealed positive fluorescent antinuclear antibodies (ANA) and anti-DNA antibody, hypocomplementemia and proteinuria (0.6_??_2.5g/day). Under the diagnosis of systemic lupus erythematosus, corticosteroid therapy was started. Thereafter to this therapy, plasmapheresis and the pulse-steroid therapy through intravenous administration daily of 1g methylprednisolone were combined. The treatment improved the urinary protein level, and she was discharged from hospital in June, 1981. From the end of 1983, however, her urinary protein was increased with frequent occurrences of hypoproteinemia associated with edema of the lower extremities. Plasma albumin transfusion was sometimes performed for treating hopoalbuminemia. In late 1985, the patient still had proteinuria, hypocomplementemia and the high ANA titer. Under instructions from her parents, she tapered steroid therapy and started special-diet therapy without our permission: a 1, 200-calorie diet per day, low in protein (30g/day) (especially animal protein) and in animal fat. Thereafter, her urinary protein was decreased. The titer of ANA and anti-DNA antibody was also decreased to the negative level in January 1988; however, hypocomplementemia has still continued. The diet low in calorie and protein, especially low in animal fat and animal protein, could exert beneficial effects on the patient in inhibiting the disease activities.