SLE: renal complications

Question 1

How should SLE patients be monitored for the development of lupus nephritis

Answer 1

urinalysis at regular check-up appointments to rule out proteinuria.

Question 2

Signs on renal biopsy

Answer 2

• glomeruli shows endothelial and mesangial proliferation
• ‘wire-loop’ appearance
• thickened capillary wall (immune complex deposition)

electron microscopy:
- subendothelial immune complex deposits
- granular appearance on immunofluorescence

Question 3

Management of lupus nephritis

Answer 3

• Treat hypertension

INITIAL TX:
glucocorticoids with either mycophenolate or cyclophosphamide

MAINTENANCE
mycophenolate > azathioprine