Lupus podocytopathy: A systematic review of clinical evidence from cases and cohorts

Department

Internal Medicine

Document Type

Article

Publication Title

Lupus

Abstract

IntroductionLupus podocytopathy (LP) is an under-recognized pathological manifestation in patients with systemic lupus erythematosus (SLE). Despite being a distinct entity, current American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) guidelines do not include specific recommendations about LP, contributing to uncertainty regarding its diagnosis and treatment. This systematic review aims to synthesize the available literature on LP from case reports, case series and retrospective cohort studies to better characterize its clinical course, thereby informing clinical decision-making.Material and methodsA systematic search of EMBASE and MEDLINE was conducted to identify relevant studies. Eligible studies included case reports, case series, and cohort studies reporting SLE patients who had biopsy-proven lupus podocytopathy without features of class III, IV, or V lupus nephritis. Demographic characteristics, clinical presentations, relevant laboratory and pathology results, treatment and outcomes were studied.ResultsThis systematic review included 26 studies (18 case reports/small series and 8 cohorts), analyzing 19 individual cases and 240 cohort patients with LP. Most patients were young females, and LP was often part of the initial lupus manifestation with nephrotic-range proteinuria. Minimal change disease (MCD) was the predominant pathology. Patients with LP had an overall favorable outcome with treatment employing systemic steroid and steroid-sparing agents.ConclusionsLP is an uncommon but distinct manifestation of SLE with overall favorable outcome with treatment using systemic steroid and steroid-sparing agents.

First Page

341

Last Page

351

DOI

10.1177/09612033261415986

Volume

35

Issue

4

Publication Date

4-1-2026

Medical Subject Headings

Humans; Lupus Erythematosus, Systemic; Female; Podocytes; Lupus Nephritis; Male; Proteinuria; Nephrosis, Lipoid; Adult

PubMed ID

41526329

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