Abstract: TH-PO0552
IgAN-Associated Systemic Lupus Erythematosus
Session Information
- Glomerular Diseases: IgAN, IgA Vasculitis, and More
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Belfquih, Oumaimah, CHU Brugmann, Brussels, Belgium
- Geers, Caroline, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Fosso, Christelle, CHU Brugmann, Brussels, Belgium
- Kamgang Semeu, Prochore, CHU Brugmann, Brussels, Belgium
Introduction
Systemic lupus erythematosus (SLE) may present as a broad spectrum of organ involvement. IgA nephropathy may be rarely associated with SLE. We aimed to describe how and when IgA nephropathy occurred during SLE, and then how nephropathy evolved.
Case Description
Case 1: A 46 yo patient was admitted for respiratory failure due to abundant bilateral pleural effusion. Laboratory tests disclosed marked inflammatory markers, normal renal function: creatinine 0,71 mg/dl, while urinalysis showed microscopic hematuria and proteinuria 0.37 g/g. The workup diagnosed SLE since he had ANA 1/160, antidsDNA Ab 38 U/ml. Evaluation of the complement was normal. Medrol 32 mg was started along with Colchicine and Hydroxychloroquine 200mg bid, and perindopril 5mg. Within 2 months, inflammatory markers reduced. Proteinuria increased up to 0,7 g/g and hematuria remained. A kidney biopsy was carried out which showed an IgA nephropathy. Creatinine slowly progressed over 2 years up to 1.20 mg/dl while proteinuria augmented: 1,23 g/g. A second biopsy was carried out which showed showed no significant evolution of IgA nephropathy. The same treatment was maintained.
Case 2: A 42 yo man was admitted for intermittent feaver, chest pains for 2 weeks. Blood tests showed inflammation: CRP 79 mg/dl, creatinine 1 mg/dl, proteinuria 0.33 g/g and microscopic hematuria. A mild pleuropericarditis was diagnosed. The workup revealed ANA 1/320, antiDNA Ab 76 U/ml, antiRNPKd68 Ab. He was discharged with Colchicine and Hydroxychloroquine. Within 20 months, creatinine raised up to 1,50 mg/dl, UPCR 0,55 g/g. Renal biopsy showed IgA nephropathy. He received methylprednisolone 24 mg and then azathioprine 150 mg was added. Two years later creatine stabilized: 1.18 mg/dl, UPCR 0.18 g/g.
Discussion
IgA nephropathy is a rare finding in the setting of SLE. Our two cases show that it occurred early after the diagnosis of SLE. Other features of SLE were pleuropericarditis. Both cases showed a progressive course with worsening renal parameters either UPCR or creatinine level. While novel therapies have emerged the last few years for Iga nephropathy, there is no recommendations for the treatment of IgA nephropathy associated systemic lupus. Cases with non-nephrotic range proteinuria may respond to RAS blocker alone. On the other hand, corticosteroid and DMARDs may be useful with evolving kidney diseases when glomerular filtration rate decreases.