Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Nephrology
Volume 2015 (2015), Article ID 231974, 4 pages
http://dx.doi.org/10.1155/2015/231974
Case Report

An Unusual Initial Presentation of Lupus Nephritis as a Renal Mass

1Nephrology Division, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4
2Pathology Department, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4
3Radiology Division, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4
4Medicine Department, Universite de Montreal, Montreal, QC, Canada H3T 1J4
5Centre de Recherche Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4

Received 29 August 2014; Revised 22 December 2014; Accepted 24 December 2014

Academic Editor: Kouichi Hirayama

Copyright © 2015 Remi Goupil et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Lupus nephritis is a frequent manifestation of systemic lupus erythematous. Lupus nephritis usually presents with abnormal urinalysis, proteinuria, and/or renal insufficiency. We report a case of a 48-year-old woman who underwent partial nephrectomy for a fortuitously discovered solid enhancing left kidney mass. No neoplastic cells were found in the biopsy specimen; however, the pathology findings were compatible with immune complex glomerulonephritis with a predominantly membranous distribution, a pattern suggestive of lupus nephritis. The mass effect was apparently due to a dense interstitial lymphocytic infiltrate resulting in a pseudotumor. Further investigation revealed microscopic hematuria with a normal kidney function and no significant proteinuria. Antinuclear antibodies were negative, although anti-DNA and anti-SSA/Rho antibodies were positive. A diagnosis of probable silent lupus nephritis was made and the patient was followed up without immunosuppressive treatment. After two years of follow-up, she did not progress to overt disease. To our knowledge, this represents the first case of lupus nephritis with an initial presentation as a renal mass.