Graca Aleksandra, Suszek Dorota, Jeleniewicz Radosław, Majdan Maria
Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Poland.
Reumatologia. 2020;58(5):331-334. doi: 10.5114/reum.2020.100105. Epub 2020 Oct 20.
Nephrotic syndrome (NS) can be a symptom of many autoimmune, metabolic, or infectious diseases. Kidney involvement is often observed in the course of diabetes mellitus (DM) and systemic lupus erythematosus (SLE). The development of NS with coexisting SLE and DM generates serious diagnostic problems. In this paper, the authors present diagnostic and therapeutic dilemmas in a patient with long-lasting DM, SLE, and secondary antiphospholipid syndrome, in whom NS symptoms appeared. Histopathological examination of the kidney confirmed the diagnosis of lupus nephritis. Immunosuppressive and anticoagulant drugs were used. The authors demonstrated that the character of morphologic lesions in the kidney biopsy can help in diagnosis, nephropathy classification, and further therapeutic decisions, which are distinct in both diseases.
肾病综合征（NS）可能是许多自身免疫性、代谢性或感染性疾病的症状。糖尿病（DM）和系统性红斑狼疮（SLE）病程中常出现肾脏受累情况。同时存在SLE和DM时NS的发生会引发严重的诊断问题。在本文中，作者介绍了一名患有长期DM、SLE和继发性抗磷脂综合征且出现NS症状患者的诊断和治疗困境。肾脏组织病理学检查确诊为狼疮性肾炎。使用了免疫抑制和抗凝药物。作者证明，肾脏活检中形态学病变的特征有助于诊断、肾病分类以及进一步的治疗决策，这两种疾病的这些方面有所不同。
