Abstract

SILVANO, José et al. A case of lupus podocytopathy and a review of the literature. Port J Nephrol Hypert [online]. 2021, vol.35, n.1, pp.39-42.  Epub Mar 31, 2021. ISSN 0872-0169.  https://doi.org/10.32932/pjnh.2021.04.116.

Nephrotic syndrome in systemic lupus erythematosus patients with histological evidence of minimal change disease, mesangial proliferation or focal and segmental glomerulosclerosis on light microscopy, represents a distinct clinical entity - lupus podocytopathy. This entity is characterized by a diffuse foot process effacement on electron microscopy and by absence of subepithelial or subendothelial immune‑complex deposition. We report the case of a 49‑year‑old woman admitted on suspicion of lupus nephritis flare, characterized by nephrotic syndrome and acute kidney injury, whose renal biopsy revealed histological features of lupus podocytopathy. Six months after discharge, under prednisolone and azathioprine, she presented 300 mg/day proteinuria, normal kidney function, without hematuria. A review of the pathogenesis, clinical features, diagnostic criteria, treatment and prognosis of lupus podocytopathy is provided. This case highlights the mounting evidence that lupus podocytopathy encompasses distinct clinical and morphological features, that should be included in the upcoming pathological classification of lupus nephritis.

Keywords : Acute kidney injury; nephrotic syndrome; podocytes; proteinuria; systemic lupus erythematosus..

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