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Lupus
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Rapidly progressive lupus glomerulonephritis and concomitant microangiopathy in an adolescent

J S Blake

University of California, Davis Medical Center, Sacramento, California, USA

L Butani

Section of Pediatric Nephrology, University of California, Davis Medical Center, 2516 Stockton Boulevard, Ticon II building, 3rd Floor, Sacramento, CA 95817, USA lavjay.butani{at}ucdmc.ucdavis.edu

We describe our experience managing a 16-year-old girl with systemic lupus erythematosus (SLE) who presented concomitantly with rapidly progressive glomerulonephritis (RPGN) and a thrombotic microangiopathic hemolytic anemia (TMAHA). Her renal biopsy showed evidence of diffuse proliferative glomerulonephritis without glomerular microthrombi. The patient was treated with a combination of intravenous corticosteroids and cyclophosphamide,as well as plasmapheresis, with an excellent response resulting in complete disease remission. The purpose of our report is to make health professionals more aware of TMAHA as a complication of SLE, since the occurrence of TMAHA may confuse the clinical picture, and since its treatment with plasmapheresis is life saving, if performed early.

Key Words: glomerulonephritis • hemodialysis • lupus • microangiopathic-hemolytic anemia • plasmapheresis • renal failure

Lupus, Vol. 11, No. 8, 533-535 (2002)
DOI: 10.1191/0961203302lu227cr
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