Negativization of antinuclear, anti-dsDNA, and anti-chromatin antibodies after vitamin D supplementation in a lupus patient.

BACKGROUND: A previous study have evaluated that antinuclear antibodies (ANA) negativization is linked to low lupus disease activity. AIM: To describe a lupus patient who evolved with negativization of ANA, anti-dsDNA, and anti-chromatin antibodies after vitamin D supplementation. METHOD: Case report. RESULTS: A 56-year-old female patient, diagnosed with systemic lupus erythematosus since 2015 characterized by typical malar erythema, photosensitivity, polyarthritis, leucopenia, positive antinuclear antibody, anti-dsDNA, and anti-chromatin antibody. She received hydroxychloroquine and prednisone. After 1 year, corticotherapy was tapered off, and no clinical evidence of lupus activity was registered (SLEDAI = 0). However, ANA remained positive with a titer of 1:640 with a homogeneous pattern, and positive anti-dsDNA 1/20 and anti-chromatin 97 Units (normal range: <20 Units) remained all-time positive. Treatment with vitamin D 25,000 IU/day was initiated, and during follow-up, anti-chromatin and anti-dsDNA disappeared. In 2019, the patient was asymptomatic, keeping SLEDAI = 0, negative anti-dsDNA and anti-chromatin, and surprisingly the ANA turned negative, which was confirmed on several occasions until now. CONCLUSION: This case adds knowledge to the understanding that negative antinuclear antibodies appear to be associated with a better prognosis in lupus patients. Furthermore, the use of vitamin D seems to be a complementary therapeutic tool for this purpose.