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Systemic lupus erythematosus (SLE) is a chronic, inflammatory,
autoimmune, multisystem connective multi system connective tissue
disease characterized by various autoantibodies to nuclear and cytoplasmic
antigens and commonly affects the joints and a variety of organs due to an
over activation of the body's immune system. There is wide heterogeneity in
presentation of SLE patients, including lung, central nervous system, skin,
kidney, and hematologic manifestations. The presence of antinuclear
antibodies (ANA) in serum is generally considered a decisive diagnostic sign
of SLE. However, a small subset of SLE patients who had the typical clinical
features of SLE was reported to show persistently negative ANA tests. Our
report describes a 24-yr-old female who presented with the clinical
manifestations of SLE such as malar rash, photosensitivity, arthritis, oral
ulcer, and proteinuria. The serum autoantibodies were all negative except
anti ribosomal P. She was also positive for lupus anticoagulantanti -
coagulant. She was treated with oral prednisolone , hydroxychloroquine
with topical tacrolimus, and improved significantly. Three months after,
repeat ANA, and anti-ds DNA showed persistent negativity, but lupus anti -
coagulant remained positive. This case suggests that ANA may not be
required in the pathogenesis of SLE.

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How to Cite
Gomes, R. R., Deepankar Kumar Basak, Kaniz Rahman, & Md. Rashidul Hasan. (2021). A young lady with ANA negative SLE and Secondary Anti Phospholipid Syndrome. Indonesian Journal of Rheumatology, 12(2), 327-332.