Abstract
Renal thrombotic microangiopathy (TMA) is an uncommon vascular complication of systemic lupus erythematosus (SLE). The diagnosis of TMA in a setting of SLE is challenging since both share common features of clinical appearance and pathology. Carefully tracing the cause of TMA is mandatory for the therapeutic plans and prognostic evaluation of this renal vasculopathy in SLE. We present a case of a 52 year-old Asian lady with SLE who developed poorly controlled hypertension, deteriorating renal function and proteinuria. The renal biopsy was compatible with lupus nephritis, class IMA, and TMA, which was rarely seen in the literature. She responded well to pulse therapy with methylprednisolone and cyclophosphamide and the administration of warfarin.
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