Lupus podocytopathy: An important differential diagnosis of nephrotic syndrome in systemic lupus erythematosus

Abstract

Some patients with systemic lupus erythematosus (SLE) present with sudden onset of nephrotic syndrome and biopsy findings may be of minimal change disease or focal segmental glomerulosclerosis with diffuse foot process effacement on electron microscopy but without significant immune deposits. This entity is termed lupus podocytopathy. Clinicians and renal pathologists need to be aware of this condition. Though steroid sensitive, it needs follow-up to recognize flare and class change, thereby optimizing therapy.

Minimal Change Nephrotic Syndrome in a Child with Systemic Lupus Erythematosus

“…In the description of two cases with lupus podocytopathy in 2016 from India, the authors presented a 22-year-old woman and a 36-year-old man who presented with features of SLE and nephrotic syndrome. [ 9 ] While the serology was positive, the histology showed no immune deposits and they responded to steroids in four weeks. The authors cautioned that lupus podocytopathy could indicate lupus activity or flare-up.…”