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SLE — SCE Rheumatology MCQ

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ModerateSLE & Antiphospholipid SyndromeSLESCE Rheumatology

A 25-year-old woman with SLE develops class V membranous lupus nephritis with proteinuria of 4 g/day but preserved eGFR. Which treatment approach is recommended?

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Correct answer: E — Mycophenolate mofetil with low-dose glucocorticoids

Pure class V membranous lupus nephritis with nephrotic-range proteinuria warrants immunosuppressive therapy. EULAR 2023 recommends Mycophenolate mofetil as the preferred agent. Calcineurin inhibitors may be considered as add-on therapy. The full NIH high-dose Cyclophosphamide regimen is typically reserved for severe proliferative nephritis. Observation alone is only appropriate for non-nephrotic proteinuria with preserved renal function.

Reference: EULAR 2023 - Recommendations for the management of systemic lupus erythematosus