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When Negative Isn’t Always Positive: A Rare Case of ANA-Negative Lupus Nephritis

Shine Vazhappilly

Guru | Internal Medicine, Rheumatology

Presented at: 2025 Florida Society of Rheumatology Annual Meeting

Date: 2025-06-19 00:00:00

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Summary: Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by multisystem involvement and autoantibody production. 2–5% of cases are ANA-negative. ANA-negative lupus nephritis is rarer and may present with non-classic autoantibodies. Histopathology typically mirrors classic lupus nephritis, therefore, diagnosis may rely on clinical criteria and tissue biopsies rather than serological markers. Clinicians should maintain a high index of suspicion for lupus nephritis in appropriate clinical contexts, despite a negative ANA test.