Systemic lupus erythematosus – the discrepancy between renal impairment and clinical and immunological manifestations

Systemic lupus erythematosus (SLE) is the prototype of autoimmune diseases with multiorgan involvement, most commonly targeting the skin, joints and kidneys. The existence and type of renal involvement influence the prognosis and this information may be crucial when it comes to establishing the optimal therapy. We present the case of a patient with SLE with skin involvement (vasculitis), joint manifestations and immunological markers remitted under synthetic remissive treatment but with severe renal damage diagnosed at the renal biopsy as a glomerulosclerosis type focal segmental podocytopathy (FSGS) collapsing variant associated with a possible ultrastructural defect of the glomerular basement membrane in the context of the disease with a severe prognosis