@article{3104908,
    title = "The Various Forms of Nephrotic Syndrome in a Patient with Systemic Lupus Erythematosus",
    author = "Lionaki, S. and Liapis, G. and Vallianou, K. and Vergadis, C. and Boletis, I.",
    journal = "Case Reports in Nephrology",
    year = "2020",
    volume = "2020",
    publisher = "Hindawi Limited",
    issn = "2090-6641, 2090-665X",
    doi = "10.1155/2020/7869216",
    keywords = "antinuclear antibody;  complement;  cyclophosphamide;  cyclosporine;  double stranded DNA antibody;  fosinopril;  glucocorticoid;  hydroxychloroquine;  methylprednisolone;  mycophenolate mofetil;  prednisolone, adult;  anasarca;  Article;  case report;  Caucasian;  clinical article;  creatinine blood level;  drug dose reduction;  drug megadose;  drug withdrawal;  fatigue;  female;  follow up;  glomerulonephritis;  hematuria;  human;  human cell;  human tissue;  kidney biopsy;  leukopenia;  low drug dose;  lupus erythematosus nephritis;  lupus podocytopathy;  lymphadenopathy;  membranous glomerulonephritis;  middle aged;  musculoskeletal disease;  protein urine level;  proteinuria;  rash;  relapse;  remission;  systemic lupus erythematosus",
    abstract = "Kidney involvement is frequent in patients with systemic lupus erythematosus (SLE), although it may not be present from disease onset. Renal lupus itself is highly heterogenous with respect to the combination and/or severity of clinical and/or laboratory manifestations. This is a case of a 45-year-old Caucasian female with an established diagnosis of SLE, who presented four times with new onset of proteinuria during a follow-up time of ten years, since the diagnosis of SLE. Specifically, she experienced two episodes of lupus membranous nephropathy, and after she achieved remission, she developed twice overt nephrotic syndrome associated with new and biopsy proven lupus podocytopathy. All these episodes of nephrotic syndrome were combined with systemic symptoms, attributed to lupus itself, while serological activity of lupus was also noted. This case highlights the importance of performing a kidney biopsy in all patients with SLE who have new renal manifestations, including nephrotic proteinuria. © 2020 Sophia Lionaki et al."
}