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We present a case of microhematuria, proteinuria and hypocomplementemia which developed in a 55-year-old female who was being treated with an infliximab biosimilar for rheumatoid arthritis. Renal biopsy showed lupus nephritis (ISN/RPS classification class IV + V). Treatment with the infliximab biosimilar was discontinued, and treatment with prednisolone, hydroxychloroquine and abatacept was started, resulting in clinical remission of lupus nephritis and RA. Although tumour necrosis factor-α α inhibitors are known to induce production of autoantibodies, symptoms are usually limited to skin involvement or arthritis, and renal complications are rare. Physicians should be aware of the risk of lupus nephritis and carefully monitor patients for the development of renal involvement during treatment with tumour necrosis factor-α inhibitors.
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http://dx.doi.org/10.1093/mrcr/rxad061 | DOI Listing |
Cureus
August 2025
Medicine and Surgery, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND.
is a protozoan parasite that typically causes self-limited diarrhea in healthy individuals but can result in prolonged, severe illness in those who are immunocompromised. While this infection is well recognized in HIV-positive patients, it is less frequently reported in individuals with lupus nephritis on immunosuppressive therapy. We report the case of a 27-year-old man with biopsy-confirmed class IV lupus nephritis who was receiving cyclophosphamide and corticosteroids.
View Article and Find Full Text PDFFront Immunol
September 2025
Clinical Immunology Department, Pasteur Institute of Tunis, Tunis, Tunisia.
Introduction: Anti-neutrophil cytoplasmic antibodies (ANCAs) have been reported in systemic lupus erythematosus (SLE). Their clinical significance remains unclear especially in the African populations. This study aimed to assess the prevalence, antigenic targets, and clinical correlations of ANCAs in SLE patients in a Tunisian (North African) cohort.
View Article and Find Full Text PDFFront Med (Lausanne)
August 2025
Nephrology Department, The First Affiliated Hospital of Army Medical University, Chongqing, China.
Background: Biological agents targeting B-cell pathways represent significant advances in systemic lupus erythematosus (SLE) management, yet optimal patient selection remains challenging. This study evaluated whether BAFF/APRIL expression testing could guide personalized treatment decisions in SLE patients.
Methods: In this real-world observational study, we compared two treatment strategies in 86 SLE patients: personalized therapy with telitacicept in BAFF/APRIL double-positive patients ( = 14) versus conventional belimumab therapy without expression testing ( = 72).
Curr Opin Immunol
September 2025
Univ. Grenoble Alpes, CNRS, CEA, UMR5075, IBS, Laboratoire d'Immunologie, CHU Grenoble Alpes, Grenoble, France.
The complement system plays a paradoxical role in systemic lupus erythematosus physiopathology, acting both as a protective mechanism and as a driver of tissue injury, depending on disease stage. Neutrophil extracellular traps (NETs) further exacerbate disease activity by promoting complement activation and autoantigen exposure, forming an amplifying inflammatory loop. Lupus nephritis remains challenging to monitor using conventional complement biomarkers such as CH50, C3, and C4; the utility of anti-C1q, anti-ficolin, and anti-C1s antibodies, along with tissue-based markers such as renal C4d and C5b-9 deposits, as markers of disease activity and prognosis, is discussed.
View Article and Find Full Text PDFSemin Arthritis Rheum
August 2025
Grupo IRIDIS (Investigation in Rheumatology and Immune-Diseases), Instituto de Investigación Sanitaria Galicia Sur, (IISGS), Hospital Universitario Vigo, Vigo, Spain.
Introduction: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disorder characterized by multi-organ involvement and variable clinical manifestations. Recurrent clinical patterns suggest distinct phenotypes, where cluster analysis of autoantibodies could identify prognostic subtypes.
Objectives: To define and describe serological clusters and their clinical-epidemiological characteristics, as well as their association with comorbidities, disease activity measures, severity, and damage.