Dominguez Davalos Marco, De La Flor José C, Bedia Castillo Carlos, Lipa Chancolla Roxana, Rodríguez Tudero Celia, Apaza Jacqueline, Zamora Rocío, Cieza-Terrones Michael
Department of Nephrology, Hospital Cayetano Heredia, Lima 15002, Peru.
Faculty of Medicine, Peruana Cayetano Heredia University, Lima 15002, Peru.
Med Sci (Basel). 2024 Dec 16;12(4):74. doi: 10.3390/medsci12040074.
Lupus podocytopathy (LP) is a non-immune complex-mediated glomerular lesion in systemic lupus erythematosus (SLE), characterized by the diffuse effacement of podocyte processes without immune complex deposition or with only mesangial immune complex deposition. LP is a rare cause of nephrotic syndrome in SLE patients with implications for prognosis and treatment.
We present the case of a 28-year-old woman with a medical history of type 1 diabetes mellitus (T1DM) who presented with lower limb edema, dyspnea, hypercholesterolemia, with nephrotic range proteinuria, without acute kidney injury, and laboratory findings compatible with auto-immune hemolytic anemia. They had negative infectious serology, positive antinuclear antibody (ANA), and an eye fundus examination showing diabetic retinopathy. A biopsy was performed to define the etiology of the renal involvement, which was compatible with LP. Following immuno-suppressive and antiproteinuric therapy, the patient evolved with the complete remission of the nephrotic syndrome.
Lupus podocytopathy is an infrequent anatomopathological entity, so this case is presented as the first reported in Peru, and a literature review is made.
狼疮性足细胞病（LP）是系统性红斑狼疮（SLE）中一种非免疫复合物介导的肾小球病变，其特征是足细胞突起弥漫性消失，无免疫复合物沉积或仅伴有系膜免疫复合物沉积。LP是SLE患者肾病综合征的罕见病因，对预后和治疗有影响。
我们报告一例28岁1型糖尿病（T1DM）病史的女性患者，其表现为下肢水肿、呼吸困难、高胆固醇血症，伴有肾病范围蛋白尿，无急性肾损伤，实验室检查结果符合自身免疫性溶血性贫血。其感染血清学检查阴性，抗核抗体（ANA）阳性，眼底检查显示糖尿病视网膜病变。进行了活检以明确肾脏受累的病因，结果符合LP。经过免疫抑制和抗蛋白尿治疗后，患者肾病综合征完全缓解。
狼疮性足细胞病是一种罕见的解剖病理学实体，因此本病例是秘鲁首次报道，并进行了文献综述。
