title: Focal segmental glomerulosclerosis lagged behind the onset of rheumatoid arthritis by 7 years: A case report and literature review.
abstract: BACKGROUND
  The co-existence of focal segmental glomerulosclerosis (FSGS) and rheumatoid arthritis (RA), presenting either together or in succession, is very rare. A variety of histopathological features in the clinical renal disease may occur in RA. Only 8 studies have previously reported this poorly understood connection.
  
  
  RESULTS
  A case of a 54-year-old male with RA lasting for more than 7 years developed cheirarthritis as the first signs. Symmetric polyarthralgia and multiple swollen joints throughout the body were followed, accompanied with morning stiffness. Gradually, he suffered from albuminuria, hypoalbuminemia, edema, and hyperlipidemia in 2014. The patient had the history of administering loxoprofen, celecoxib, leflunomide, and methotrexate. He was diagnosed as RA, nephrotic syndrome. Renal biopsy confirmed FSGS.
  
  
  CONCLUSIONS
  Our case and the review of the literature indicate that FSGS is one of the causes of nephrotic syndrome in RA. It strongly suggested that RA patients with the abnormal kidney functions should be routinely screened for FSGS to guide the therapy, achieve both RA and FSGS remission, determine a prognosis, and avoid end-stage renal lesion.
authors.affiliation: Department of Rheumatology, Shanxi Medical University, the Second Hospital of Shanxi Medical University, N0.382 Wu Yi Road Taiyuan, Shanxi Province Department of Nephrology Department of Pathology, Shanxi Medical University, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Wen
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Wang
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D001706:Biopsy / Q000379:methods; D003937:Diagnosis, Differential; D019468:Disease Management; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000209:etiology