A Case of Lupus Nephritis Preceded by Minimal Change Disease and Membranous Glomerulonephritis

03 April 2023: Articles

Unusual clinical course, Mistake in diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents

Fengxia Zhang ^A , Nan Jiang ^B , Karthick Kumaran Munisamy Selvam ^B , Bohou Li ^B , Qiong Wu ^B , Sichun Wen ^B , Ruiquan Xu ^D* , Shuangxin Liu ^A

DOI: 10.12659/AJCR.938402

Am J Case Rep 2023; 24:e938402

Table 2. Clinical and Laboratory findings during the 3 instances of renal biopsies.

Parameters	First renal biopsy	Second renal biopsy	Third renal biopsy	Normal range
Blood pressure (mmHg)	126/81	155/113	126/81	–
Serum creatinine (mg/dL)	1.53	0.92	7.51	0.65–1.26
Serum urea (mmol/L)	8.5	3.4	22.64	3.1–8
Serum albumin (g/L)	10.8	19.6	14.2	35–55
Hb (g/L)	152	85	71	120–180
24h urine protein (g)	3.8	8.1	1.5
Hematuresis (/µl)	10	564.3	1498.4	0–12
Serum a-PLA2R	∼	∼	1:64	>1: 20
ANA	Negative	Negative	1+	Negative
Anti-dsDNA (IU/ml)	Negative	Negative	>200.0	0–10
ENA	Negative	Negative	–	Negative
c-ANCA	–	Negative	Negative	Negative
p-ANCA	–	Negative	1+	Negative
MPO (RU/mL)	0.0–19.9	–		0.0–19.9
PR3 (RU/mL)	0.0–19.9	–	36.9	0.0–19.9
GBM (U/mL)	∼	∼	3.6	0.0–19.9
C3 in serum (mg/L)	Within normal limits	Within normal limits	489	900–1800
C4 in serum (mg/L)	Within normal limits	Within normal limits	74	100–400
ANA antinuclear antibody; anti-dsDNA anti-double-stranded DNA; ENA xtractable nuclear antigen; ANCA perinuclear antineutrophil cytoplasmic antibody; MPO myeloperoxidase; PR3 roteinase 3; GBM glomerular basement membrane. “∼” specific laboratory test not done; “–” negative.