A new case study entitled “Acute kidney injury associated with minimal change disease in systemic lupus erythematosus: a case report” describes a rare case of a patient with Systemic lupus erythematosus and acute kidney injury associated with minimal change disease. The study was published in the Journal of Medical Case Reports.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, thus, a condition where the body’s own immune system overreacts and attacks healthy tissue. Thus, this type of disease is characterized by the presence of auto-antibodies and deposits of immune complexes throughout the body. When these deposits occur in the kidneys, the disease is known as lupus nephritis. In SLE cases, the occurrence of damage to the kidneys’ glomeruli (the filtering unit of the kidney, together with Bowman’s capsule, where blood is filtered to form urine), a condition referred to as minimal change disease, is a rare reported event.
In this case study, the authors describe the case of a 26-year-old Chinese woman with SLE that exhibited acute kidney injury due to minimal change disease. The occurrence of these three conditions is considered extremely rare, however, since the treatment for lupus nephritis and minimal change disease is different the authors, after this case, recommend as a first approach a renal biopsy so that other nephrotic diseases can be excluded.
In this case, the patient presented proteinuria (a condition characterized by the excessive presence of serum proteins in the urine, and thus may a sign of kidney damage) at the time of her lupus diagnosis. However, since no renal biopsy was performed at the time, whether these conditions developed simultaneously or the contrary is unknown. As a result, a renal biopsy will allow differentiating patients with lupus and severe proteinuria, and recommending an appropriate therapeutics. According to the literature, the authors reported 13 cases of SLE associated with minimal change disease — with both conditions developing at the same time in five cases, while SLE developed after minimal change disease in three. Conversely, minimal change disease developed during SLE was reported in five patients.
In light of these findings, the authors highlight the need to perform further studies in order to understand if patients with SLE are more prone to develop minimal change disease or if both conditions, in fact, occur simultaneously.