저자들은 5년 전 IgA 신병증을 진단받고 치료중이던 21세 여자 환자가 경부 림프절 종대로 내원하여 아급성 괴사성 림프절염으로 진단받고 치료중 임상양상 및 혈청학적 검사로 루푸스가 확인되었으며, 신장 조직 검사상 루푸스 신염으로 진단하여 치료한 1예를 경험하고 문헌 고찰과 함께 보고하는 바이다.

Renal involvement in systemic lupus erythematosus (SLE) is a typical manifestation of the disease. The occurrence of non-lupus nephritis, especially IgA nephropathy (IgAN), in patients with SLE has rarely been reported. We describe the case of a 21-year-old woman who was diagnosed with IgAN and subacute necrotizing lymphadenitis, and her renal lesion biopsy was typical of lupus nephritis (ISN/RPS Class III). Although IgAN and lupus nephritis share some common physiopathological characteristics, their laboratory, histopathologic findings, and the extra-renal clinical manifestations are different and support a different pathogenesis. Our case highlights the importance of a renal biopsy in patients with lupus and urinary alterations despite underlying IgAN. A correct diagnosis would permit the most appropriate immunosuppressive treatments to be considered.