An Unusual Initial Presentation of Lupus Nephritis as a Renal Mass

Abstract EN

Lupus nephritis is a frequent manifestation of systemic lupus erythematous.

Lupus nephritis usually presents with abnormal urinalysis, proteinuria, and/or renal insufficiency.

We report a case of a 48-year-old woman who underwent partial nephrectomy for a fortuitously discovered solid enhancing left kidney mass.

No neoplastic cells were found in the biopsy specimen; however, the pathology findings were compatible with immune complex glomerulonephritis with a predominantly membranous distribution, a pattern suggestive of lupus nephritis.

The mass effect was apparently due to a dense interstitial lymphocytic infiltrate resulting in a pseudotumor.

Further investigation revealed microscopic hematuria with a normal kidney function and no significant proteinuria.

Antinuclear antibodies were negative, although anti-DNA and anti-SSA/Rho antibodies were positive.

A diagnosis of probable silent lupus nephritis was made and the patient was followed up without immunosuppressive treatment.

After two years of follow-up, she did not progress to overt disease.

To our knowledge, this represents the first case of lupus nephritis with an initial presentation as a renal mass.