title: An unusual initial presentation of lupus nephritis as a renal mass.
abstract: Lupus nephritis is a frequent manifestation of systemic lupus erythematous. Lupus nephritis usually presents with abnormal urinalysis, proteinuria, and/or renal insufficiency. We report a case of a 48-year-old woman who underwent partial nephrectomy for a fortuitously discovered solid enhancing left kidney mass. No neoplastic cells were found in the biopsy specimen; however, the pathology findings were compatible with immune complex glomerulonephritis with a predominantly membranous distribution, a pattern suggestive of lupus nephritis. The mass effect was apparently due to a dense interstitial lymphocytic infiltrate resulting in a pseudotumor. Further investigation revealed microscopic hematuria with a normal kidney function and no significant proteinuria. Antinuclear antibodies were negative, although anti-DNA and anti-SSA/Rho antibodies were positive. A diagnosis of probable silent lupus nephritis was made and the patient was followed up without immunosuppressive treatment. After two years of follow-up, she did not progress to overt disease. To our knowledge, this represents the first case of lupus nephritis with an initial presentation as a renal mass.
authors: Nephrology Division, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4.
authors: Remi
authors: 0000-0002-0098-3735
authors: R
authors: Goupil
authors: Nephrology Division, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4.
authors: Annie-Claire
authors: 0000-0002-7755-1404
authors: AC
authors: Nadeau-Fredette
authors: Pathology Department, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4.
authors: Virginie
authors: V
authors: Royal
authors: Radiology Division, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4.
authors: Alexandre
authors: 0000-0002-8953-4871
authors: A
authors: Dugas
authors: Nephrology Division, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4 ; Medicine Department, Universite de Montreal, Montreal, QC, Canada H3T 1J4 ; Centre de Recherche Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4.
authors: Jean-Philippe
authors: 0000-0001-7876-0446
authors: JP
authors: Lafrance
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