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16 Management of lupus nephritis
  1. YK Onno Teng
  1. Leiden University Medical Center (LUMC), The Netherlands


The therapeutic armamentarium of the lupologist is expanding, notably when faced with one of the most frequent severe systemic lupus erythematosus (SLE) organ manifestation: Lupus nephritis (LN). Based on real-practice case studies, we will address the latest guideline recommendations for the management of LN. With novel agents at hand, we will make a journey through several treatment strategies for LN and provide key learnings by interactive discussions.

Case 1: 20-year-old woman with LN A 20-year-old female with no significant pathological history presented with arthritis, facial rash and leg swelling. She was recently diagnosed SLE and treated prednisolone and hydroxychloroquine, calcium, and active vitamin D. Three months later she developed nephrotic syndrome and mild hypertension, her laboratory results showed a creatinine 123 mmol/L (1.5 mg/dL), positive antinuclear antibodies 1:1280, anti-double-stranded DNA 1230 U/mL and low C3 and C4. Her urine sediment showed glomerular erythrocyturia. A kidney biopsy was performed confirming active LN. After an interactive discussion on histopathological findings, a therapeutic decision must be made.

Learning Objectives

  • Describe at least four treatment goals for your LN patient

  • Summarize three treatment options for induction of remission in LN

  • Discuss three treatment options for preventing relapses in LN

  • Explain the pathophysiology of glomerulonephritis in SLE

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