A case of systemic lupus erythematosus after taking oral contraceptives

In December 1986 a 29 year old woman developed nephrosis due to systemic lupus erythematosus after taking oral contraceptives (OC) for 6.5 years. Hospitalized for 3 months she received steroid treatment which lowered albumin in urine. At the time of hospitalization the following symptoms were noted. Edema on all her limbs 4.5 g/dl of urine albumin per day white blood cell count of 2600/mm 640 time positive anti-nuclear antibodies pseudo-positive response to syphilis via bentonite flocculation on particle (BFP). OC she had taken since 1980 were 0.5 mg of norgestrel day and 0/05 mg of ethinyl estradiol day. She had been routinely checked on her kidney function biannually and everything had been normal till then. For 2 months starting in December 1987 at the patients request progesterone along (dydrogesterone 10 mg/day) was administered for contraception. No urine albumin was detected. It appears that autoimmune-type thyroid gland abnormality preceded systemic lupus erythematosus (SLE) which was triggered by the oral contraceptive use. Estrogen metabolism of SLE patients is characterized by estrogen active 16 alpha hydroxyestrone.