A 32-year-old woman with known systemic lupus erythematosus develops rising creatinine, proteinuria 2.5 g/day, and urinary red cell casts. Blood press...

Question

A 32-year-old woman with known systemic lupus erythematosus develops rising creatinine, proteinuria 2.5 g/day, and urinary red cell casts. Blood pressure is 148/92 mmHg. Which is the most appropriate next step?

Accepted Answer

Refer urgently to nephrology for kidney biopsy and immunosuppressive therapy

Answer

Start low-dose prednisone and continue hydroxychloroquine only

Answer

Start NSAIDs for symptomatic relief

Answer

Stop hydroxychloroquine

Answer

Reassure and repeat urinalysis in one year

ca-rcpsc-im MCQ (SBA): Lupus nephritis

A 32-year-old woman with known systemic lupus erythematosus develops rising creatinine, proteinuria 2.5 g/day, and urinary red cell casts. Blood pressure is 148/92 mmHg. Which is the most appropriate next step?