MESANGIAL LUPUS NEPHRITIS WITH ASSOCIATED NEPHROTIC SYNDROME

Patients with mesangial proliferative lupus glomerulonephritis (World Health Organization class II) are generally believed to have only mild to moderate proteinuria and normal renal function. However, there hav e been several reports of patients with mesangial lupus with nephrotic -range proteinuria. In this report, we present two additional cases an d review the literature. Of seven reported cases, persistent nephrotic syndrome was observed in four, morphologic transformation occurred in three, and all but one presented with varying degrees of azotemia. Th ese cases reinforce the concept that in systemic lupus erythematosus, laboratory findings may not correlate well with the underlying glomeru lar lesion, and therefore, the renal biopsy is an essential clinical t ool in the approach to lupus nephritis.