Concepedia

Abstract

You are working as an internal medicine resident in a rheumatology rotation and are seeing a 19 year-old woman who has had systemic lupus erythematosus diagnosed on the basis of a characteristic skin rash, arthritis, and renal disease. A renal biopsy has shown diffuse proliferative nephritis. A year ago, her creatinine was 140 micromoles/litre, six months ago 180, and in a blood sample taken a week before this clinic visit, 220. Over the last year she has been taking prednisone, and over the last six months, cyclophosphamide, both in appropriate doses.

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