Introduction
Systemic lupus erythematosus (SLE) is a protean disease. The
classification criteria have been evolving to increase the sensitivity
and specificity of SLE diagnosis. The American College of Rheumatology
(ACR) criteria (1982 version 1and 1997 revised
version2 have high specificity, but limited
sensitivity. The Systemic Lupus International Collaborating Clinics
(SLICC) 2012 criteria have increased sensitivity, but decreased
specificity3. The 2019 EULAR/ACR SLE classification
criteria have both high sensitivity and specificity, and advocated
positive ANA (ever) as an entry criterion4, 5.
Therefore, for patients with persistent ANA negative, it is difficult to
diagnosis for SLE. Our report describes a young woman who presented an
ANA negative and lack of typical clinical symptoms of SLE patient, but
with severe lupus-like manifestations. At present, this is unique case
report about severe lupus with ANA continued negative.