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Systemic lupus erythematosus — SCE Rheumatology MCQ

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HardConnective Tissue DiseasesSystemic lupus erythematosusSCE Rheumatology

A patient with SLE has proteinuria, haematuria, rising anti-dsDNA and low complement. Urine protein has been quantified and infection excluded. What investigation best guides immunosuppressive treatment?

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Correct answer: C — Use kidney biopsy to classify lupus nephritis

The best answer is “Use kidney biopsy to classify lupus nephritis”. Suspected active lupus nephritis generally requires biopsy to classify the lesion and distinguish treatable activity from chronic damage. ANA titre, nailfold assessment, muscle imaging and joint aspiration do not provide renal histology or select nephritis treatment.

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