Moysés-Neto Miguel, Costa Roberto S, Rodrigues Fernanda F, Vieira Neto Osvaldo M, Reis Marlene A, Louzada Júnior Paulo, Romão Elen A, Dantas Márcio
Faculty of Medicine of Ribeirão Preto , University of São Paulo , Ribeirão Preto, SP , Brazil.
Faculty of Medicine of Triângulo Mineiro , Federal University of Triângulo Mineiro , Uberaba, MG , Brazil.
NDT Plus. 2011 Feb;4(1):20-2. doi: 10.1093/ndtplus/sfq179. Epub 2010 Oct 22.
Some patients with systemic lupus erythematosus (SLE) present with nephrotic syndrome due to minimal change disease (MCD). Histopathological diagnosis of patients with SLE and nephrotic-range proteinuria has shown that these patients present with diffuse proliferative glomerulonephritis and membranous glomerulonephritis, World Health Organization (WHO) classes IV and V, respectively, more frequently than the other classes. In the present study, we reported a case of nephrotic syndrome and renal biopsy-proven MCD associated with SLE. A complete remission occurred after steroid treatment, which was followed by a relapse 15 months later with a concomitant reactivation of SLE. A second biopsy showed WHO class IIb lupus nephritis. Prednisone treatment was restarted, and the patient went into complete remission again. The association of MCD and SLE may not be a coincidence, and MCD should be considered as an associated SLE nephropathy.
一些系统性红斑狼疮（SLE）患者因微小病变病（MCD）而出现肾病综合征。对SLE和肾病范围蛋白尿患者的组织病理学诊断表明，这些患者出现弥漫性增殖性肾小球肾炎和膜性肾小球肾炎，分别为世界卫生组织（WHO）IV级和V级，比其他级别更为常见。在本研究中，我们报告了1例与SLE相关的肾病综合征且经肾活检证实为MCD的病例。类固醇治疗后实现完全缓解，15个月后复发，同时SLE再次活动。第二次活检显示为WHO IIb级狼疮性肾炎。重新开始泼尼松治疗，患者再次完全缓解。MCD与SLE的关联可能并非巧合，MCD应被视为一种相关的SLE肾病。
