Kurginian Kseniia, Stolyarevich Ekaterina, Novikov Pavel, Moiseev Sergey, Bulanov Nikolay
Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
Chair of Nephrology, Federal State Budget Educational Institution of Higher Vocational Education «Russian University of Medicine», Moscow, Russian Federation.
Nephrology (Carlton). 2025 Aug;30(8):e70111. doi: 10.1111/nep.70111.
Lupus nephritis (LN) is one of the most common renal manifestations of systemic lupus erythematosus (SLE). However, conditions other than LN can result in a rapid decline in kidney function. We present a clinical case of a young patient with SLE who developed arterial hypertension, arthralgia and morning stiffness in knee and hand joints, an increase in serum creatinine levels from 194 to 532 mol/L, proteinuria of 1.65 g/L and thrombocytopenia of 1000/μL. Kidney biopsy showed isolated antiphospholipid antibody nephropathy (aPL-N) without any signs of proliferative LN or tubulointerstitial nephritis. The patient was treated with low-molecular-weight heparin, followed by warfarin (target INR 2.0-3.0), low-dose glucocorticoids and azathioprine, resulting in SLE remission and partial recovery of kidney function. This study demonstrates that isolated aPL-N can cause a rapid decline in kidney function in patients with SLE. To avoid diagnostic errors, kidney biopsy should be performed in a timely manner in all patients with SLE according to standard indications.
