Question

A 29-year-old woman with systemic lupus erythematosus presents with nephrotic-range proteinuria and declining renal function. Renal biopsy confirms class IV lupus nephritis. What is the most appropriate initial immunosuppressive regimen?

Accepted Answer

High-dose corticosteroids plus mycophenolate mofetil or cyclophosphamide

Answer

Low-dose prednisone alone

Answer

Azathioprine monotherapy at low dose

Answer

NSAIDs and ACE inhibitor only

Answer

No immunosuppression; monitor only

Practice question

A 29-year-old woman with systemic lupus erythematosus presents with nephrotic-range proteinuria and declining renal function. Renal biopsy confirms class IV lupus nephritis. What is the most appropriate initial immunosuppressive regimen?