Closer to the dream of remission?

It's 30 minutes before my phone consultation with the rheumatologist. Last check-up, my test results were so good that I don't need a physical appointment. While I wait for the clock to strike 10:00, I google what the most common finding in kidney biopsies in lupus patients are. After reading the abstract from two studies I find (Wen, 2011 and Kar & Ganiger, 2019), I'm mentally prepared that the most common finding seems to be class 3 and class 4. Of which class 4 is supposed to be the worst. Still, I have an underlying feeling that I won't get any really bad news today either. I'm feeling great, and my test results were so good last time, it would be weird if this has suddenly changed dramatically. But I try to keep my optimism in check,  before these chek-ups. «Drammen Hospital Rheumatalogist». The call lights up the phone screen.

After a 20-minute conversation, I call my mom smiling. The doctor is very happy with the test results and the disease activity is now even lower than last time. Regarding the kidney biopsy, there were not enough glomeruli in the tissue sample, so they could not classify the nephritis. The glomeruli are tiny clusters of blood vessels of which there are about 1 million in each kidney (large medical encyclopedia). The clusters filter and purify the blood and this is where the infamous autoantibodies can decide to settle down and make havoc. They study these clusters under a microscope and look for changes. Although there were not enough of these to classify the nephritis, it was enough to confirm the lupus nephritis diagnosis. But, since I respond so well to the medication and the tests are back normal again, I don't have to worry about the kidneys, nor do I have to take a new biopsy. Protein is no longer leaking into the urine and it all looks very promising! In other words, there is every reason to smile! So I can consider myself healthy for now and we'll just have to see how it develops. The next check-up will be in Drammen in 3 months. The most important thing going forward is protecting myself from the sun and avoiding stress. 

"Poison stress is" - Yoda 
​

Sources:
Kar, D. P. & Ganiger, V. C. (2019). Renal biopsy findings in lupus nephritis and their correlation with clinical and biochemical parameters. Kidney International reports. VOLUME 4, ISSUE 7, SUPPLEMENT, S317, JULY 01, 2019. https://www.kireports.org/article/S2468-0249(19)31017-4/fulltext
Wen, Y. (2011). Renault biopsy findings in new-ondet systemic lupus erythematosus with clinical renal disease. In. Urol Nephrol, Sep; 43 (3): 801-6.doi: 10.1007 / s11255-011-9911-3. Epub 2011 Feb 20. https://pubmed.ncbi.nlm.nih.gov/21336956/