Rapidly progressive glomerulonephritis due to SLE

Introduction:Rapidly progressive glomerulonephritis (RPGN) is clinically characterized by nephritic syndrome with rapid deterioration of renal function, progressing to end stage renal disease (ESRD) within months from the onset. Renal biopsy reveals so-called crescentic glomerulonephritis, characterized by extra capillary proliferation in 50% of glomeruli. Case report:We present 38 years old female with history of Wernicke aphasia from month ago that all work ups for patient (brain MRI and neck vein color-Doppler sonography) were normal. In primary lab dates her Creatinine was mmol/l. in initial evaluation her creatinine was increased to mmol/l and she had hematuria and more than 2500 mg/dl proteinuria. Immediately methylprednisolone (2500 mg) and cyclophosphamide (750 mg) was started for patient. In secondary evaluations lab dates showed ANA positive. So the most likely diagnosis was stage or mixed 4-5 lupus nephritis. The patient became candidate for kidney biopsy. Discussion and conclusion:From pathological point of view taking into account the presence of autoAbs, RPGN can be stratified into major groups: anti-glomerular basement membrane (GBM) autoAb disease (type I), immune complex disease (type II), and pauci-immune disease (type III). Of note, proper classification is difficult and many RPGN cases remain idiopathic. Diagnosis the etiology of Rapidly Progressive Glomerulonephritis is very important for decisions the type of treatment, prognosis and follow up. Without treatment ESRD and mortality is common