Table 1

Clinical and laboratory profile of the three patients

Patient APatient BPatient C
Age of SLE diagnosis281432
EthnicityAfricanIndianAsian
Features at SLE diagnosis
 Cutaneous
 Arthritis
 Serositis
 Neurologic
 Haemolytic anaemia
 Leucopenia
 Thrombocytopenia		+
+
+
−
+
−
−		+
+
+
–
–
–
–		–
+
–
–
–
+
–
Initial serology
 ANA
 Pattern
 Anti-dsDNA
 Anti-Ro
 C3 (g/L)
 Anticardiolipin
 IgM
 IgG
 DRVVT		>1:320
Diffuse
+
+
0.69
–
–
–		>1:320
Speckled+diffuse
+
+
1.21
–
–
–		>1:320
Nucleolar+diffuse
+
+
1.11
–
–
–
Progress of SLE
(non-renal)		Multiple arthritis flares (2003–2010)
First trimester miscarriage (2007)
Pleurisy (2009)
Myocarditis (2009)
Renal abscesses (2010)
Pyelonephritis (2010)		Multiple arthritis and rash flares (2006–2017)
Vasculitis in fingers and toes (2007/2012)
Alopecia (2007)
Dyspnoea, mouth ulcers and headaches (2008)
Shingles and chest infection (2008)
Acute liver injury secondary to NSAIDs (costochondritis) (2016)		Multiple arthritis flares (2005–2017)
Discoid lupus (2005)
Raynaud (2008)
Pneumonia (2014)
Pulmonary cysts and calcified nodules (2015)
Rash (2017)
Initial renal tests
 Serum creatinine (µmol/L)
 eGFR (mL/min/1.73 m2)
 Proteinuria 
 Haematuria
 Urinary protein/creatinine ratio (mg/mmol)		75
97
–
–
5 		70
95
–
–
8 		63
95
–
–
3 
Features suggesting renal involvement
 Hypertension
 Proteinuria
 Haematuria
 Serum creatinine (µmol/L)
 eGFR (mL/min/1.73 m2)
 Urinary protein/creatinine ratio (mg/mmol)
 Oedemas		+
+++
++
190
30
438
+		+
++++
+++
83
69
986
+		–
+++
++
89
59
273
–
Biopsy findingsVery active diffuse proliferative changesPatchy background parenchymal oedema. No chronic damage. Mix pattern immune complex glomerulopathy. Endocapillary and extracapillary active proliferation and membranous changeVery active diffuse proliferative changes
WHO LN classIVIV+VIV
Time of LN diagnosis in years after SLE diagnosis191715
Therapeutic for LN
 Prednisolone
 Cyclophosphamide
 Mycophenolate mofetil
 Rituximab		+
–
+
–		+
–
+
+		+
–
+
+
Outcome of LN
Duration of follow-up		Partial remission with evolution to chronic kidney disease
5 years		Complete remission
4 months		Active
2 months

  • DRVVT, dilute Russell viper venom time; eGFR, estimated glomerular filtration rate; LN, lupus nephritis; NSAID, non-steroidal anti-inflammatory drug.