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SLE — SCE Rheumatology MCQ

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HardConnective tissue diseasesSLESCE Rheumatology

A patient with SLE develops persistent proteinuria 0.72 g/day, dysmorphic haematuria and a 12% fall in eGFR. Complements are low. What investigation should guide classification and treatment?

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

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Correct answer: D — Kidney biopsy after excluding infection and other reversible causes

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

B is correct. EULAR/ERA-EDTA recommends considering kidney biopsy when proteinuria exceeds 0.5 g/day or there is otherwise unexplained kidney dysfunction. Histology distinguishes proliferative, membranous, chronic and thrombotic lesions that require different treatment. Serology cannot assign class, ultrasound cannot show activity or chronicity, and a nephrotic-range threshold would delay care.

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