Objective To investigate the clinical features,diagnosis and differential diagnosis methods,causes of misdiagnosis and preventive measures of lupus nephritis(LN).Methods The case data of 7 patients with LN who were misdiagnosed as purpura nephritis and rheumatoid arthritis from March 2020 to June 2022 were retrospectively analyzed.Results Among the 7 patients,5 were males and 2 were females,aged 26-57 years.Fever,arthralgia,fatigue and weakness,loss of appetite,and night sweats of hands and limbs were the main manifestations in 2 patients.The white blood cells and platelet counts were slightly decreased,hemoglobin was decreased,and erythrocyte precipitation rate was increased.X-ray ex-amination showed slight swelling of soft tissues around the affected joints and slight narrowing of joint space.They were initial-ly diagnosed with rheumatoid arthritis,and the condition did not improve significantly after receiving anti rheumatic drugs and external application of traditional Chinese medicine.Upon further examination of the patient's own antibodies and renal biop-sy,the diagnosis was confirmed as LN.The main manifestations of the 5 patients were rash,arthralgia,lower limb edema,oli-guria,and lumbago.Proteinuria,hematuria,abnormal renal function were found on routine urine examination,purpura nephri-tis was initially diagnosed,and LN was confirmed by pathological examination through renal puncture.The pathological types of LN were 2 cases of type Ⅱ,4 cases of type Ⅲ and 1 case of type Ⅳ.The misdiagnosis of 7 patients lasted 1-2 months.Af-ter diagnosis,all patients were treated with Prednisone combined with Cyclophosphamide and symptomatic supportive treat-ment,showing stable condition.Conclusion The clinical manifestations of LN patients are varied,some of them are atypical in the early stage,and a few of them only show kidney damage,which is more likely to cause misdiagnosis before autoantibody examination and renal biopsy.Clinicians should strengthen the understanding of the complexity of LN's multi-system manifes-tations,strengthen the understanding of the characteristics and diagnostic knowledge of the disease,enhance vigilance,and perform careful differential diagnosis,early autoantibody examination and renal biopsy,which is conducive to reducing the misdiagnosis and mistreatment of the disease.
维普
万方数据