{"id":"https://openalex.org/W7220650493","doi":"https://doi.org/10.3389/fimmu.2026.1941706","title":"Phenotypic shift from active class IV lupus nephritis to lupus podocytopathy: a case report highlighting the treatment-altering role of repeat kidney biopsy","display_name":"Phenotypic shift from active class IV lupus nephritis to lupus podocytopathy: a case report highlighting the treatment-altering role of repeat kidney biopsy","publication_year":2026,"publication_date":"2026-10-06","ids":{"openalex":"https://openalex.org/W7220650493","doi":"https://doi.org/10.3389/fimmu.2026.1941706","pmid":"https://pubmed.ncbi.nlm.nih.gov/42903163","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13680228"},"language":"en","primary_location":{"id":"doi:10.3389/fimmu.2026.1941706","doi":"https://doi.org/10.3389/fimmu.2026.1941706","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1941706","pdf_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1941706/pdf","source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1941706/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5157765676","display_name":"Zhifa Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210121761","display_name":"First Affiliated Hospital of Fujian Medical University","ror":"https://ror.org/030e09f60","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210121761"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Zhifa Wang","raw_affiliation_strings":["Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University","institution_ids":["https://openalex.org/I4210121761"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5051250426","display_name":"Jinxiu Deng","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210121761","display_name":"First Affiliated Hospital of Fujian Medical University","ror":"https://ror.org/030e09f60","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210121761"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Jinxiu Deng","raw_affiliation_strings":["Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University","institution_ids":["https://openalex.org/I4210121761"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157677396","display_name":"Jinfeng Shen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210121761","display_name":"First Affiliated Hospital of Fujian Medical University","ror":"https://ror.org/030e09f60","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210121761"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Jinfeng Shen","raw_affiliation_strings":["Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University","institution_ids":["https://openalex.org/I4210121761"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157776855","display_name":"Hui Jiang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210121761","display_name":"First Affiliated Hospital of Fujian Medical University","ror":"https://ror.org/030e09f60","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210121761"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hui Jiang","raw_affiliation_strings":["Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University","institution_ids":["https://openalex.org/I4210121761"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5157738232","display_name":"Fuzhen Wang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210121761","display_name":"First Affiliated Hospital of Fujian Medical University","ror":"https://ror.org/030e09f60","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210121761"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Fuzhen Wang","raw_affiliation_strings":["Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University","institution_ids":["https://openalex.org/I4210121761"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5157738232"],"corresponding_institution_ids":["https://openalex.org/I4210121761"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.7607362,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"17","issue":null,"first_page":"1941706","last_page":"1941706"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10308","display_name":"Systemic Lupus Erythematosus Research","score":0.7202000021934509,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10308","display_name":"Systemic Lupus Erythematosus Research","score":0.7202000021934509,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":0.27639999985694885,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.0008999999845400453,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/lupus-nephritis","display_name":"lupus nephritis","score":0.8970000147819519},{"id":"https://openalex.org/keywords/class-iv-lupus-nephritis","display_name":"class IV lupus nephritis","score":0.9679999947547913},{"id":"https://openalex.org/keywords/lupus-podocytopathy","display_name":"lupus podocytopathy","score":0.9909999966621399},{"id":"https://openalex.org/keywords/repeat-kidney-biopsy","display_name":"repeat kidney biopsy","score":0.7789999842643738},{"id":"https://openalex.org/keywords/thrombotic-microangiopathy","display_name":"thrombotic microangiopathy","score":0.9010000228881836},{"id":"https://openalex.org/keywords/focal-segmental-glomerulosclerosis","display_name":"focal segmental glomerulosclerosis","score":0.9399999976158142},{"id":"https://openalex.org/keywords/podocyte-foot-process-effacement","display_name":"podocyte foot process effacement","score":0.8970000147819519},{"id":"https://openalex.org/keywords/tacrolimus","display_name":"tacrolimus","score":0.925000011920929},{"id":"https://openalex.org/keywords/immune-complex-deposits","display_name":"immune complex deposits","score":0.6029999852180481},{"id":"https://openalex.org/keywords/serological-remission","display_name":"serological remission","score":0.6959999799728394},{"id":"https://openalex.org/keywords/immunosuppression-intensification","display_name":"immunosuppression intensification","score":0.5899999737739563},{"id":"https://openalex.org/keywords/precision-medicine","display_name":"precision medicine","score":0.4880000054836273}],"concepts":[{"id":"https://openalex.org/C2779912601","wikidata":"https://www.wikidata.org/wiki/Q1621830","display_name":"Lupus nephritis","level":3,"score":0.8044000267982483},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7950999736785889},{"id":"https://openalex.org/C2776912625","wikidata":"https://www.wikidata.org/wiki/Q1485","display_name":"Systemic lupus erythematosus","level":3,"score":0.5927000045776367},{"id":"https://openalex.org/C2781087799","wikidata":"https://www.wikidata.org/wiki/Q7312483","display_name":"Renal biopsy","level":3,"score":0.5135999917984009},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.5085999965667725},{"id":"https://openalex.org/C163764329","wikidata":"https://www.wikidata.org/wiki/Q785022","display_name":"Autoantibody","level":3,"score":0.48190000653266907},{"id":"https://openalex.org/C2775934546","wikidata":"https://www.wikidata.org/wiki/Q179991","display_name":"Biopsy","level":2,"score":0.46619999408721924},{"id":"https://openalex.org/C2779561371","wikidata":"https://www.wikidata.org/wiki/Q570197","display_name":"Proteinuria","level":3,"score":0.4537000060081482},{"id":"https://openalex.org/C2778415529","wikidata":"https://www.wikidata.org/wiki/Q1435223","display_name":"Focal segmental glomerulosclerosis","level":4,"score":0.4512999951839447},{"id":"https://openalex.org/C2780091579","wikidata":"https://www.wikidata.org/wiki/Q9377","display_name":"Kidney","level":2,"score":0.4271000027656555},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.42329999804496765},{"id":"https://openalex.org/C2780368995","wikidata":"https://www.wikidata.org/wiki/Q605006","display_name":"Glomerulonephritis","level":3,"score":0.36320000886917114},{"id":"https://openalex.org/C2781184683","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Nephropathy","level":3,"score":0.35429999232292175},{"id":"https://openalex.org/C2780199430","wikidata":"https://www.wikidata.org/wiki/Q3347169","display_name":"Glomerulopathy","level":4,"score":0.3156999945640564},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3070000112056732},{"id":"https://openalex.org/C2777878052","wikidata":"https://www.wikidata.org/wiki/Q3312044","display_name":"Thrombotic microangiopathy","level":3,"score":0.2937000095844269},{"id":"https://openalex.org/C2777146197","wikidata":"https://www.wikidata.org/wiki/Q138912","display_name":"Podocyte","level":4,"score":0.2930999994277954},{"id":"https://openalex.org/C45189115","wikidata":"https://www.wikidata.org/wiki/Q502159","display_name":"Serology","level":3,"score":0.27489998936653137},{"id":"https://openalex.org/C2777390665","wikidata":"https://www.wikidata.org/wiki/Q5571239","display_name":"Glomerulosclerosis","level":4,"score":0.2700999975204468},{"id":"https://openalex.org/C2775915377","wikidata":"https://www.wikidata.org/wiki/Q188297","display_name":"Lupus erythematosus","level":3,"score":0.2637999951839447},{"id":"https://openalex.org/C2778653478","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Kidney disease","level":2,"score":0.2563000023365021},{"id":"https://openalex.org/C2780130043","wikidata":"https://www.wikidata.org/wiki/Q192360","display_name":"Autoimmunity","level":3,"score":0.25450000166893005},{"id":"https://openalex.org/C127716648","wikidata":"https://www.wikidata.org/wiki/Q104053","display_name":"Phenotype","level":3,"score":0.2506999969482422}],"mesh":[{"descriptor_ui":"D001706","descriptor_name":"Biopsy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005923","descriptor_name":"Glomerulosclerosis, Focal Segmental","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":false},{"descriptor_ui":"D005923","descriptor_name":"Glomerulosclerosis, Focal Segmental","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007166","descriptor_name":"Immunosuppressive Agents","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D007668","descriptor_name":"Kidney","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":true},{"descriptor_ui":"D008181","descriptor_name":"Lupus Nephritis","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D008181","descriptor_name":"Lupus Nephritis","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D008181","descriptor_name":"Lupus Nephritis","qualifier_ui":"Q000276","qualifier_name":"immunology","is_major_topic":true},{"descriptor_ui":"D008181","descriptor_name":"Lupus Nephritis","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":true},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010641","descriptor_name":"Phenotype","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011507","descriptor_name":"Proteinuria","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":false},{"descriptor_ui":"D016559","descriptor_name":"Tacrolimus","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D050199","descriptor_name":"Podocytes","qualifier_ui":"Q000187","qualifier_name":"drug effects","is_major_topic":true},{"descriptor_ui":"D050199","descriptor_name":"Podocytes","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":true},{"descriptor_ui":"D055815","descriptor_name":"Young Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.3389/fimmu.2026.1941706","doi":"https://doi.org/10.3389/fimmu.2026.1941706","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1941706","pdf_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1941706/pdf","source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13680228","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13680228/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13680228/pdf/fimmu-17-1941706.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Immunol","raw_type":"Text"},{"id":"pmid:42903163","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42903163","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in immunology","raw_type":"Case Reports"},{"id":"pmh:oai:doaj.org/article:a5d9235d17b04de6a69cc758b89e57e5","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/a5d9235d17b04de6a69cc758b89e57e5","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Immunology, Vol 17 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fimmu.2026.1941706","doi":"https://doi.org/10.3389/fimmu.2026.1941706","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fimmu.2026.1941706","pdf_url":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1941706/pdf","source":{"id":"https://openalex.org/S2595292759","display_name":"Frontiers in Immunology","issn_l":"1664-3224","issn":["1664-3224"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Immunology","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9789000153541565,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220650493.pdf","grobid_xml":"https://content.openalex.org/works/W7220650493.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W2144479843","https://openalex.org/W2330445159","https://openalex.org/W2733476948","https://openalex.org/W2783430372","https://openalex.org/W2927871970","https://openalex.org/W2970392040","https://openalex.org/W2983329556","https://openalex.org/W3014011850","https://openalex.org/W3021154423","https://openalex.org/W3159830316","https://openalex.org/W3200479416","https://openalex.org/W4300089761"],"related_works":["https://openalex.org/W7208774233","https://openalex.org/W4414155773","https://openalex.org/W45214655","https://openalex.org/W4395004547","https://openalex.org/W3094121640","https://openalex.org/W4411433331","https://openalex.org/W2998388128","https://openalex.org/W4389397038","https://openalex.org/W4403832916","https://openalex.org/W2991127985"],"abstract_inverted_index":{"Background:":[0],"The":[1,100],"underlying":[2],"pathophysiological":[3],"mechanisms":[4],"of":[5,71,83,130,136],"proteinuria":[6,58],"relapse":[7],"in":[8,112,118,125],"lupus":[9],"nephritis":[10],"(LN)":[11],"patients":[12],"during":[13],"immunological":[14],"remission":[15,62],"are":[16],"complex,":[17],"often":[18],"involving":[19],"non-immune":[20],"complex-mediated":[21],"podocyte":[22,96],"injury.":[23],"Case":[24],"presentation:":[25],"We":[26],"report":[27],"a":[28,105,113],"21-year-old":[29],"male":[30],"with":[31,94],"class":[32],"IV":[33],"LN":[34],"and":[35,42,66,115,148],"thrombotic":[36],"microangiopathy":[37],"(TMA).":[38],"After":[39],"multi-target":[40],"induction":[41],"maintenance":[43],"therapy,":[44],"the":[45,126],"patient":[46],"achieved":[47],"complete":[48],"clinical":[49,138],"remission.":[50],"During":[51],"subsequent":[52],"follow-up,":[53],"he":[54],"developed":[55],"progressive":[56],"nephrotic-range":[57],"while":[59],"maintaining":[60],"serological":[61],"(persistently":[63],"negative":[64],"autoantibodies":[65],"normal":[67],"complement":[68],"levels).":[69],"Intensification":[70],"conventional":[72],"immunosuppressants":[73],"was":[74,102],"ineffective.":[75],"A":[76],"repeat":[77,132],"kidney":[78,133],"biopsy":[79,134],"revealed":[80],"significant":[81,137],"resolution":[82],"immune":[84],"complex":[85],"deposits":[86],"but":[87],"prominent":[88],"focal":[89],"segmental":[90],"glomerulosclerosis":[91],"(FSGS)-like":[92],"changes":[93],"extensive":[95],"foot":[97],"process":[98],"effacement.":[99],"regimen":[101],"adjusted":[103],"to":[104],"podocyte-targeted":[106],"therapy":[107],"centered":[108],"on":[109],"tacrolimus,":[110],"resulting":[111],"rapid":[114],"sustained":[116],"reduction":[117],"proteinuria.":[119],"Conclusion:":[120],"This":[121],"case":[122],"suggests":[123],"that":[124],"clinico-serological":[127],"dissociation":[128],"phase":[129],"LN,":[131],"is":[135],"value":[139],"for":[140],"identifying":[141],"pathological":[142],"phenotypic":[143],"shifts,":[144],"avoiding":[145],"excessive":[146],"immunosuppression,":[147],"guiding":[149],"precision":[150],"medicine.":[151]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-10-07T00:00:00"}