Transformation of Relapsed Membranous Nephropathy to Proliferative Lupus Nephritis. A Case Report:

  • Fayaz Ahmad Sofi Department of Rheumatology SKIMS
  • Mushtaq Ahmad
  • Bilal Ahmad Rather Department of Medicine, SKIMS
Keywords: SLE, Lupus Nephritis

Abstract

SSLE is a dynamic disease. Lupus nephritis occurs in 40%-70% of patients. Renal biopsy is performed to know various classes of lupus nephritis. In several studies of lupus nephritis, type IV nephritis is the most common [approximately 40%] whereas type III and type V follow with an approximate frequency of 25% and 15%. The transformation from one class to another can occur, spontaneously and as a result of treatment. Prognosis is worse when membranous and
proliferative changes coexist. In Pub Med search from 1999-2015, 9 patients of class V have changed to mixed ( IV+V) and none out of 6 patients in the study by Narveiz et al: to class ( IV + V), though in one case transformation to class ( 111/1V+V) was reported.Our case report transformed from relapsed class V to mixed class( IV+V)

Author Biography

Fayaz Ahmad Sofi, Department of Rheumatology SKIMS

M.D., Professor

References

1. Weening JJ, D’Agati VD, Schwartz MM, et al: The classification of glomerulonephritis in SLE
revisited kidney. int 65:521-530,2004.
2. Spramgers B, Monahan M, Appel GB. Diagnosis and treatment of lupus nephritis flares-an
update. Nat Rev Nephrol 2012; 8:709-17. [PubMed]
3. Daleboudt GM, Bajema IM, Goemare NT, et al. The clinical relevance of a repeat biopsy in lupus
nephritis flares. Nephrol Dial Transplant 2009:24:3712-7. [PubMed]
4. WeeningJJ,D’Agati VD, Schwartz MM, et al. the classification of glomerulonephritis in systemic
lupus erythematosus revisited. J Am SocNephrol 2004:15:241-50. [PubMed]
5. Haladyj E, Cervera R. Do we still need renal biopsy in lupus nephritis? Reumatologia
2016;54:61-6. [PMC free article] [PubMed]
6. Greloni G, Scolnik M, Marin J, et al. Value of repeat biopsy in lupus nephritis flares. Lupus Sci
Med 2014;1:e000004. [PMC free article] [PubMed]
7. Alsuwaida AO. The clinical significance of serial kidney biopsies in lupus nephritis. Mod
Rheumatol 2014;24:453-6. [PubMed]
8. Pagni F, Galimberti S, Goffredo P, et al. The value of repeat biopsy in the management of
lupusnephritis:an international multicenter study in a large cohort of patients. Nephrol Dial
Transplant 2013;28:014-23. [PubMed]
9. Wang GB, Xu ZJ, Liu HF, et al. changes in pathological pattern and treatment regimes based on
repeat renal biopsy in lupus nephritis. Chin Med J [Eng] 2012;125:2890-4. [PubMed]
10. Lu J, Tam LS, Lai FM, et al. Repeat renal biopsy in lupus nephritis: a change in histological
pattern is common, Am J Nephrol 2011;34:220-5. [PubMed]
11. Sun HO, Hu WX, Xie HL, et al. long term outcome of Chinese patients with membranous lupus
nephropathy. Lupus 2008;17:56-61. [PubMed]
12. Bajaj S, Albert L, Gladman DD, et al. Serial renal biopsy in systemic lupus erythematosus. J
Rheumatol 2000;27:2822-6. [PubMed]
13. Moroni G, Pasquali S, Quaglini S, et al. Clinical and prognostic value of serial renal biopsies in
lupus nephritis. Am J Kidney Dis 1999;34:530-9. [PubMed]
14. Esdaile JM, Joseph L, MacKenzie T, et al. The pathogenesis and prognosis of lupus nephritis:
information from repeat renal biopsy. Semin Arthritis Rheum 1993;23:135-48. [PubMed]
15. https://www,ncbi.nlm.nih.gov/pmc/articles/PMC5478313/
Published
2019-05-27
How to Cite
1.
Sofi FA, Ahmad M, Rather BA. Transformation of Relapsed Membranous Nephropathy to Proliferative Lupus Nephritis. A Case Report:. jms [Internet]. 2019May27 [cited 2019Jul.19];22(1):78-0. Available from: http://jmsskims.org/index.php/jms/article/view/409
Section
Case Reports