03 April 2023
: Case report 
A Case of Lupus Nephritis Preceded by Minimal Change Disease and Membranous Glomerulonephritis
Unusual clinical course, Mistake in diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents
Fengxia Zhang1A, Nan Jiang2BCDEF, Karthick Kumaran Munisamy Selvam1BCDEF, Bohou Li2BC, Qiong Wu2BC, Sichun Wen3BC, Ruiquan Xu4DEF*, Shuangxin Liu2AFGDOI: 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 | <0.15 |
| 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 | – | <2.0 | 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. | ||||