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Class V LN Treatment — SCE Rheumatology MCQ

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ModerateSLE & Antiphospholipid SyndromeClass V LN TreatmentSCE Rheumatology

A 35-year-old woman with SLE has class V membranous lupus nephritis with proteinuria 4.5g/day. What treatment approach does EULAR 2023 recommend?

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Correct answer: C — Immunosuppressive therapy (MMF or CNI-based regimen) is recommended for class V LN with proteinuria >1g/day to reduce proteinuria and prevent progression

EULAR 2023: class V (membranous) LN with proteinuria >1g/day warrants immunosuppression. MMF or CNI-based regimen (Tacrolimus Voclosporin) or combination (multitarget therapy). Pure class V has lower risk of ESRD than III/IV but significant proteinuria causes long-term damage.

Reference: EULAR 2023 SLE; Rovin BH 2021