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首页> 外文期刊>Journal of the Canadian Rheumatology Association >If It’s Not One Thing It’s Another: Transformation of Lupus Nephritis
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If It’s Not One Thing It’s Another: Transformation of Lupus Nephritis

机译：如果不是一回事，那是另一回事：狼疮肾炎的转变

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摘要

A 25-year-old Haitian-born woman presents for her routine follow-up appointment. She was diagnosed with sys-temic lupus erythematosus (SLE) a year ago. Her disease features at presentation consisted of discoid skinlesions, photosensitivity, alopecia, oral ulcers, polyarthritis, leucopenia, lymphopenia, Coombs positive hemolyt-ic anemia, and thrombocytopenia. Her serology was positive for ANA, anti-dsDNA, anti-Sm and anti-RNP anti-bodies. When first seen, she was found to have lower limb edema and her work-up showed a normal serum cre-atinine, low C3 and C4, hypoalbuminemia (30 g/L) and microscopic hematuria. A 24-hour urine collectionrevealed non-nephrotic range proteinuria (1.32 g/day). A kidney biopsy done at that time showed class III (A)lupus nephritis (LN) (Figure 1). The patient was started on high dose oral prednisone, mycophenolate mofetil(MMF), and hydroxychloroquine. Due to a severe skin reaction to MMF, treatment was changed to azathioprine
机译：一名25岁的海地出生妇女出席了她的例行随访。一年前，她被诊断出患有系统性红斑狼疮（SLE）。她的疾病表现包括盘状皮肤病，光敏性，脱发，口腔溃疡，多关节炎，白细胞减少症，淋巴细胞减少症，库姆斯氏阳性溶血性贫血和血小板减少症。她的血清学对ANA，抗dsDNA，抗Sm和抗RNP抗体呈阳性。初诊时发现她有下肢水肿，其检查结果显示血清cre-atinine正常，C3和C4低，低白蛋白血症（30 g / L）和镜下血尿。 24小时尿液收集显示非肾病范围蛋白尿（1.32 g /天）。当时进行的肾脏活检显示为III级（A）狼疮肾炎（LN）（图1）。该患者开始使用高剂量口服泼尼松，霉酚酸酯（MMF）和羟氯喹。由于皮肤对MMF的严重反应，治疗改为硫唑嘌呤

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