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A 29-year-old pregnant woman with systemic lupus erythematosus was admitted to the hospital because of renal failure at 20 weeks 6 days of gestation.
The patient, a native of Panama, had been in good health until she was 21 years of age, when pain and swelling developed in the distal and proximal interphalangeal joints of both hands and feet. An evaluation at a hospital in her native country led to a diagnosis of systemic lupus erythematosus. Low-dose prednisone was administered, and the joint inflammation resolved.
Approximately three years before admission, the nephrotic syndrome developed. A renal biopsy performed at the
Differential Diagnosis
Preeclampsia
Lupus Nephritis in Pregnancy
A Challenging Differential Diagnosis
Discussion of Management
Clinical Diagnosis
Dr. Winfred W. Williams, Jr.'s, Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Division of Nephrology, Department of Medicine (W.W.W., R.I.T.), and the Departments of Transplant Surgery (W.W.W.), Obstetrics, Gynecology, and Reproductive Biology (J.L.E.), and Pathology (A.R.), Massachusetts General Hospital; and the Division of Nephrology, Department of Medicine (W.W.W., R.I.T.), and the Departments of Obstetrics, Gynecology, and Reproductive Biology (J.L.E.), and Pathology (A.R.), Harvard Medical School.
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