Нетипичный Клинический Случай Системной Красной Волчанки С Волчаночным Нефритом

In this article, an unusual case of systemic lupus erythematosus (SLE) with lupus nephritis is presented. The disease started with the articular syndrome, as in rheumatoid arthritis, and lasted for 5 years with a positive rheumatoid factor and anti-cyclic citrullinated polypeptide and fulfilled the classification criteria for diagnosis of rheumatoid arthritis. Only 5 years later after the onset of the disease, the patient developed nephropathy without the skin or any organs and systems lesion. The kidney biopsy was carried out and lupus nephritis (LN) was diagnosed. LN is considered one of the most frequent severe manifestations of SLE, its various manifestations occur in at least 50% of SLE patients, both at the onset and at various stages of the disease, and the development of LN is considered one of the most important predictors of mortality in SLE. To confirm the diagnosis, evaluate the prognosis and choose the tactics to treat the disease. All patients in the absence of contraindications, need a kidney biopsy. In addition to LN, the spectrum of SLE-associated renal lesions includes vascular pathology represented by thrombotic microangiopathy, lupus vasculopathy or vasculitis, tubulointerstitial injury, and lupus podocytopathy. Biopsy is the only method to diagnose LN, which also allows distinguishing the morphological form of LN.