A Case of Proliferative and Membranous Lupus Nephritis Complicated by Cryoglobulin-like Hyaline Thrombi

Introduction: Renal disease is a devastating complication of systemic lupus erythematosus (SLE). In addition to glomerular involvement, vascular disease is not uncommon. We present a case of lupus nephritis (LN) in the setting of thrombotic microangiopathy (TMA) with a rare instance of cryoglobulin-like thrombi. Case: a 21-year-old woman with past medical history of SLE complicated by Class VI nephritis was admitted with worsening kidney function which showed a serum creatinine of 2.9 mg/dL from a baseline of <1.5. She reported shortness of breath, cough, and a headache. She endorsed compliance with all of her medications and did not notice any urine output changes. Blood pressure was 200/123. On exam malar rash, Cushingoid appearance, and hair loss was …