Long-standing SLE can cause glomerulosclerosis, but this patient is at her first presentation. Some patients with lupus nephritis also have hypertension, as this patient does, which is best treated with ACE-inhibitors or angiotensin II receptor blockers (ARBs), as these medications also help control proteinuria.Ĭrescentic glomerulonephritis, or rapidly progressive glomerulonephritis, ( choice A) presents in multiple forms: antibodies to the glomerular basement membrane (as in Goodpasture's disease), ANCA-positive, pauci-immune polyangiitis, or an idiopathic form.įocal segmental glomerulosclerosis (FSGS) ( choice B) is more common in patients with HIV, diabetes mellitus, G6PD deficiency or sickle cell disease. The most common cause of nephrotic syndrome in SLE is membranous glomerulopathy. The presentation of lupus nephritis is highly variable, including nephritic syndrome and nephrotic syndrome presentations. Renal involvement in lupus is very common and a considerable cause of morbidity and mortality. This patient has systemic lupus erythematosus (SLE) presenting with nephrotic syndrome due to secondary membranous glomerulopathy.
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