A Case of Renal-limited Lupus-like Nephritis

ABSTRACT

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that is clinically heterogeneous and affects multiple organs particularly the kidney. Lupus nephritis is a common and severe manifestation of SLE in which immune-mediated inflammation can lead to permanent damage within the kidney, resulting in end stage renal failure. Recently a renal biopsy showed lupus nephritis on a 40-year old female without any other features of SLE such as clinical symptoms and autoantibodies including antinuclear antibody and anti-dsDNA. The renal biopsy showed that histopathological change of global and segmental sclerosis of glomeluri, diffuse proliferative nephritis with crescent formation compatible with class IV lupus nephritis. She was treated with systemic corticosteroids and pulse cyclophosphamide, followed by mycofenolate mofetil. During two years of follow-up, there have been no clinical or laboratory findings to meet the diagnostic criteria of SLE, suggesting that isolated lupus nephritis could occur without SLE.