误诊为膜性肾病的狼疮肾炎临床分析OACSTPCD

Objective To explore the clinical characteristics and key points of differential diagnosis between lupus nephritis(LN)and membranous nephropathy(MN),so as to reduce misdiagnosis and mistreatment.Methods The clinical data of one patient with LN misdiagnosed for more than 10 years were analyzed retrospectively,and the related literature was reviewed.Results A woman of childbearing age presented with edema of both lower limbs and foam urine for 13 years.At the initial diagnosis more than 10 years ago,renal pathology examination revealed stage I MN,and corresponding treatment was given for alleviation.The patient's condition had been fluctuating over the past 10 years.Two months ago,the patient went to the local clinic for treatment due to gingivitis.At 4 d after treatment,there was edema in both lower limbs,increased foam in urine,and decreased urine volume,so he was transferred to our hospital.Physical examination revealed mild edema in both lower limbs,sparse hair,and pale red skin lesions on the neck skin.Diagnosis of LN was made through renal biopsy and pathological examination,and her condition improved after targeted treatment for 19 d.Conclusion Systemic lupus erythe-matosus usually involves multiple tissues,organs and systems.The kidney is one of the main organs involved,and the early clinical symptoms are atypical.When differentiating LN from MN,we should pay attention to pathological examination and the examination of the target antigen of MN,and perform careful physical examination and differential diagnosis,to reduce or avoid misdiagnosis and mistreatment.