Abstract

SANTOS, Ricardo et al. Nephrotic proteinuria in a patient with Rhupus. Port J Nephrol Hypert [online]. 2013, vol.27, n.4, pp.295-299. ISSN 0872-0169.

The kidney is often affected by connective tissue diseases and their treatments. We report the case of a 45-year-old Caucasian female who presented to our nephrology department with nephrotic proteinuria (maximum 6200 mg per day) and a history of rheumatoid arthritis (RA) treated with antimalarial, corticotherapy and non-steroidal anti-inflammatory drugs (NSAIDs). Furthermore, on clinical assessment we identified four criteria for systemic lupus erythematosus (SLE). We promptly withdrew the NSAIDs and, after 3 months without significant reduction in proteinuria, we decided to perform a renal biopsy. The histological examination found a stage 1 membranous nephropathy (suggestive of class V lupus nephritis). After less than six months without NSAIDs, there was spontaneous complete clinical remission of the nephrotic syndrome. In this paper we discuss the aetiology of the glomerular disease in this patient as an adverse effect of NSAIDs treatment versus glomerular disease associated to RA/ SLE (Rhupus)

Keywords : Lupus Nephritis; Membranous Nephropathy; Nephrotic Syndrome; Non-steroidal Anti-inflammatory Drugs; Rheumatoid Arthritis; Rhupus; Systemic Lupus Erythematosus.

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