Scenario development ...continued

Jenny has some updated blood tests which show her ESR level and dsDNA antibody titre have both risen. Her blood tests also show that her albumin is low at 24, and her renal function is impaired (estimated glomerular filtration rate 45ml/min). The rheumatologist looking after Jenny discusses the problems with a nephrologist, and with Jenny it is decided that a renal biopsy is needed. Image 5 shows Jenny’s biopsy.

Scenario Development Image 4

The left hand image shows a normal glomerulus for comparison. On the right, showing a glomerulus has narrowing/closing of the capillaries plus an abnormal increase of cells within those vessels. The histopathologist reports this as being consistent with an active lupus nephritis.