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SLE renal investigation — SCE Rheumatology MCQ

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HardMusculoskeletal investigationsSLE renal investigationSCE Rheumatology

A 35-year-old woman has photosensitive rash, inflammatory arthralgia and oral ulcers. ANA is positive, anti-dsDNA is high, C3/C4 are low and urine dip shows protein 2+ with blood 2+. Which investigation best assesses the suspected organ-threatening manifestation?

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Correct answer: D — Urine protein:creatinine ratio and renal biopsy planning

The data suggest active SLE with renal involvement, so quantifying proteinuria and arranging renal biopsy where indicated is the correct pathway. Repeating ANA adds little once specific antibodies and organ features are present. HLA-B27 and urate testing target unrelated diagnoses.

Reference: BSR SLE guideline; EULAR lupus nephritis recommendations