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Renal biopsies obtained from four adolescent girls who developed symptomatic thrombocytopenia with serologic evidence of systemic lupus erythematosus, without clinical signs of renal involvement, showed glomerular disease by electron and immunofluorescent microscopy with light microscopic changes in two cases. Subsequently, three of the patients developed proteinuria, and repeat biopsies from all four showed appearances ranging from resolution to significant glomerulitis. The findings illustrate the variable patterns of occult glomerulitis in lupus, and highlight the value of correlating light, electron and immunofluorescent studies in renal pathology.
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