[A case of minimal change nephrotic syndrome manifesting acute renal failure in the course of systemic lupus erythematosus].
A 51-year-old woman with systematic lupus erythematosus(SLE) associated with minimal change nephrotic syndrome(MCNS) is described. The patient was diagnosed as SLE at 33 years of age. After steroid therapy for two years, the patient's course was uneventful without therapy until June 2000, when facial erythema and facial, pretibial edema developed. On admission, proteinuria and renal dysfunction were detected. Subsequently, oliguric acute renal failure developed and hemodialysis was started. Laboratory examination showed no significant change in complements and anti ds-DNA antibody levels. Renal biopsy revealed minor glomerular abnormalities without the deposition of immune complexes. Electron microscopic examination showed foot process fusion and a vacuolar change in glomerular epithelial cells. The diagnosis of MCNS was made and administration of steroid(40 mg/day) was started. Urine volume and renal function improved after 2 weeks, and nephrotic syndrome remitted completely after 5 weeks. Although the association of SLE and MCNS is rare, the findings suggest that in the course of SLE manifesting acute ranal failure, not only lupus nephritis, but also the complication of MCNS should be considered.
Sugimoto
Taro
T
Okayama University Graduate School of Medicine and Dentistry, Department of Medicine and Clinical Science, Okayama, Japan.
Yamasaki
Yasushi
Y
Kobayashi
Mizuho
M
Usui
Hitomi
H
Matsuda
Mitsuhiro
M
Ohishi
Tetsuya
T
Ichikawa
Haruo
H
Nakamura
Yoshio
Y
Nagake
Yoshio
Y
Makino
Hirofumi
H
D058186:Acute Kidney Injury / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000209:etiology* / Q000473:pathology