Last update:

   09-Sep-2020
 

Arch Hellen Med, 37(Supplement 2), 2020, 187-191

CLINICAL CASE

A historical appraisal of lupus nephritis

G. Eknoyan,1 M. Airy2
1Department of Medicine, Baylor College of Medicine, Houston, Texas
2Baylor College of Medicine, Houston, Texas, USA

The understanding of lupus nephritis over the past five decades has been phenomenal. Kidney biopsy is now the gold standard for its diagnosis, evaluation and management. However, lupus nephritis is a medical entity of recent vintage. The term "lupus", derived from Latin for wolf, was introduced in the Middle Ages to label nondescript erosive skin lesions resembling wolf bites. The specific dermatologic features of lupus were characterised as a non-erosive "erythematous" butterfly rash in 1828 and termed "lupus erythematosus" in 1850. Their association with systemic manifestations was described in 1872 as "disseminated lupus erythematosus". The generic term "nephritis" was first used to describe the renal lesions of systemic lupus erythematosus (SLE) in 1902. Although albuminuria and abnormal urine sediment were often noted in SLE patients, initial studies of their renal changes was limited to post-mortem studies. Clarification of the lesions of lupus nephritis came only after the introduction of kidney biopsies in the 1950s and was refined thereafter by immunofluorescent and electron microscopic studies. Subsequent studies of lupus nephritis paralleled the emerging discipline of immunology that identified autoimmunity as the cause of SLE. The varied lesions observed in lupus nephritis were classified by glomerular changes in 1975 and refined in 2003.

Key words: Collagen diseases, Lupus erythematosus, Lupus nephritis, Nephritis, Systemic lupus erythematosus.


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