Lionaki Sophia, Liapis George, Vallianou Kalliope, Vergadis Chrysovalantis, Boletis Ioannis
Nephrology Department and Transplantation Unit, Laiko Hospital, National & Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece.
Pathology Department, Laiko Hospital, Athens, Greece.
Case Rep Nephrol. 2020 Feb 13;2020:7869216. doi: 10.1155/2020/7869216. eCollection 2020.
Kidney involvement is frequent in patients with systemic lupus erythematosus (SLE), although it may not be present from disease onset. Renal lupus itself is highly heterogenous with respect to the combination and/or severity of clinical and/or laboratory manifestations. This is a case of a 45-year-old Caucasian female with an established diagnosis of SLE, who presented four times with new onset of proteinuria during a follow-up time of ten years, since the diagnosis of SLE. Specifically, she experienced two episodes of lupus membranous nephropathy, and after she achieved remission, she developed twice overt nephrotic syndrome associated with new and biopsy proven lupus podocytopathy. All these episodes of nephrotic syndrome were combined with systemic symptoms, attributed to lupus itself, while serological activity of lupus was also noted. This case highlights the importance of performing a kidney biopsy in all patients with SLE who have new renal manifestations, including nephrotic proteinuria.
系统性红斑狼疮（SLE）患者常出现肾脏受累，尽管疾病初发时可能并无此表现。肾性狼疮在临床和/或实验室表现的组合及/或严重程度方面具有高度异质性。这是一例45岁确诊为SLE的白种女性患者，自SLE诊断后的十年随访期内，她四次出现新发蛋白尿。具体而言，她经历了两次狼疮膜性肾病发作，缓解后又两次出现与新的、经活检证实的狼疮足细胞病相关的显性肾病综合征。所有这些肾病综合征发作均伴有归因于狼疮本身的全身症状，同时也观察到狼疮的血清学活动。该病例凸显了对所有出现包括肾病性蛋白尿在内的新肾脏表现的SLE患者进行肾活检的重要性。
