A Woman With Lupus and Nephritis

A 25-year-old Asian woman was diagnosed with systemic lupus erythematosus more than 5 years previously. Her recent systemic symptoms include malar rash, photosensitivity, intermittent alopecia, occasional oral ulcers, and arthralgias involving various joints. She has been on steroids intermittently. She was started on losartan over a year prior and her blood pressure was around 125/70. She also takes hydroxychloroquine.