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SLE — SCE Rheumatology MCQ

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HardSLE & Antiphospholipid SyndromeSLESCE Rheumatology

Class IV lupus nephritis starts mycophenolate-based therapy. Baseline proteinuria is 2.4 g/day and eGFR 78 mL/min/1.73 m². At 6 months eGFR is 75. Which proteinuria result meets the minimum EULAR response milestone?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — A fall to 1.2 g/day or lower

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as E

B is correct. The 6-month EULAR milestone is at least a 50% reduction in proteinuria with stable GFR: from 2.4 g/day, that is 1.2 g/day or less. The 12-month goal is below approximately 0.5–0.7 g/day, so imposing it at month 6 is premature. Complement and anti-dsDNA support assessment but do not replace the quantitative renal target.

Reference: 2019 EULAR/ERA-EDTA lupus nephritis recommendations. https://ard.bmj.com/content/79/6/713