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Case Reports
. 2014 Dec 13:8:422.
doi: 10.1186/1752-1947-8-422.

Acute kidney injury associated with minimal change disease in systemic lupus erythematosus: a case report

Xin Wei, Ying Wang, Luxia Tu, Hongping Wan, Qinkai Chen  1
Affiliations
Case Reports

Acute kidney injury associated with minimal change disease in systemic lupus erythematosus: a case report

Xin Wei et al. J Med Case Rep. .

Abstract

Introduction: In systemic lupus erythematosus, acute kidney injury is usually associated with severe lupus nephritis and rarely associated with other glomerular diseases.

Case presentation: We recently encountered a patient with acute kidney injury that was associated with minimal change disease in systemic lupus erythematosus. A 26-year-old Chinese woman who had a history of systemic lupus erythematosus presented with nephrotic syndrome and acute kidney injury. She fulfilled four of the American College of Rheumatology criteria for the classification of systemic lupus erythematosus. However, a renal biopsy revealed that there were no glomerular abnormalities or deposition of immune complex. Her generalized edema disappeared, and her high serum creatinine level decreased to normal after prednisolone therapy.

Conclusion: Though the relationship between lupus and minimal change disease is still not defined, the possibility of systemic lupus erythematosus combined with minimal change disease must be differentiated in patients with lupus and severe proteinuria.

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Figures

Figure 1
Figure 1
Light microscopy of the patient’s renal biopsy tissue. We found that 18 glomeruli were present in the sample. The glomeruli show an almost normal appearance. The capillary lumina are patent. The basement membranes are intact and not duplicated. The mesangium is not widened and not proliferated. The interstitial space shows a multifocal, mild mononuclear cell infiltration. The tubules are minimally atrophic. The vessels are unremarkable. There is no obvious chronic damage in the kidney. Hematoxylin and eosin stain; original magnification, ×200.
Figure 2
Figure 2
Electron microscopy of the patient’s renal biopsy. This section shows a marked effacement of the foot processes of podocytes as well as a microvillous transformation The mesangial area is unremarkable. The basement membrane is irregularly wrinkled. The capillary lumina are patent. No electron deposits are visible. Uranyl acetate and lead citrate double-stain; original magnification, ×15,000.
Figure 3
Figure 3
Changes in serum creatinine levels during admission.
See this image and copyright information in PMC

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