Abstract
The patient ill this case was a 17-year-old girl with systemic lupus erythematosus （SLE)． Ten years after
onset, the SLE recurred accompanied by nephrotic syndrome． Lupus nephritis of International Society of
Nephrology class lV G（A/C）was diagnosed according to kidney biopsy results． The patient underwent 4
courses of steroid pulse therapy． but her urinary protein levels gradually increased． Her systemic symptoms
included marked edema and accumulation of pleuroperitoneal and pericardial fluids． She was admitted to the
hospital at age 17 years 6 months． Plasmapheresis was performed to eliminate autoantibodies，which improved
the nephrotic symptoms and relieved the edema and accumulated pleuroperitoneal and pericardial fluids．
Thereafter，the urinary protein levels gradually decreased． Cyclophosphamide pulse therapy was selected as
maintenance immunosuppression therapy． After 8 months， remission of the nephrotic syndrome was achieved、
Lupus nephritis is a serious complication of SLE， which can be a determining factor of patient quality
of life and prognosis． In addition to steroids， combined use of mycophenolate mofetil and cyclophosphamide
pulse therapy is necessary for the treatment of lupus nephritis class IV． In severe cases of nephrotic syndrome，
plasmapheresis is considered as all effective， life-saving treatment in the acute phase．
