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Nephrology & Renal Medicine

Class IV Diffuse Proliferative Lupus Nephritis

ICD-10 Code
M32.14_3

Severe renal manifestation of Systemic Lupus Erythematosus (SLE) characterized by subendothelial deposits, wire loop lesions, and marked endocapillary proliferation. High risk of progressive renal failure.

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents with clinical features of Class IV Lupus Nephritis, including persistent proteinuria, hematuria, and active urinary sediment. Recent labs demonstrate elevated serum creatinine, hypoalbuminemia, and active serologic markers (low C3/C4, elevated anti-dsDNA). Patient reports symptoms of fluid retention, including peripheral edema and hypertension.

Clinical Examination Findings

General appearance: Patient appears chronically ill. Vitals: Hypertension (BP >140/90 mmHg). Skin: Malar rash, alopecia, or vasculitic lesions noted. Extremities: Significant pitting edema (1+ to 3+) noted in lower extremities. Weight: Increased due to fluid retention.

Treatment Protocol

Induction therapy initiated with high-dose corticosteroids and immunosuppressive agents (e.g., Mycophenolate Mofetil or Cyclophosphamide) per protocol. ACE inhibitors/ARBs prescribed for antiproteinuric effect and blood pressure control. Monitor for opportunistic infections and cytopenias.

Detailed clinical guide coming soon.