1. Renal manifestations of lupus nephritis Although SLE mainly affects female patients, the clinical manifestations are similar in both sexes. The clinical manifestations and the degree of renal involvement are similar in adults and children. The clinical manifestations of lupus nephritis are as complex as other systemic manifestations. The renal clinical manifestations occur concurrently with or after the onset of SLE and follow a recurrent clinical course. Clinical manifestations are usually consistent with renal pathologic changes, but some patients can present with more severe vascular and tubulointerstitial lesions and less severe glomerular lesions. 2. Extra-renal clinical manifestations of lupus nephritis Because lupus is a systemic disease that accumulates multiple organs throughout the body, its clinical manifestations and disease regression are also complex and diverse. Skin lesions: The incidence of skin and mucous membranes ranges from 55% to 90%, including pteroid erythema, oral and nasal mucosal ulcers, discoid erythema, and subacute skin lesions. Joint lesions: arthritis and arthralgia are the most common, with an incidence of approximately 95% or more. Pulmonary lesions: pleurisy is the most common, with an incidence of about 40-60%, sometimes with pleural effusion. Cardiovascular lesions: The most common is pericarditis. Cardiovascular comorbidities are clinically comorbid in 1/4 of patients and positive autopsy rates are as high as 2/3. Neurological lesions: Neurological lesions are clinically diverse and can be difficult to differentiate from hormone-related neurological symptoms. They include cognitive impairment, headache, altered state of consciousness (rigidity to coma), seizures, stroke, optic neuritis, and peripheral neuropathy. Hematologic lesions: Hematologic complications including lymphadenopathy can involve 50% of patients with SLE. Nearly half of the patients are associated with anemia, which manifests as hemolytic anemia and a positive direct Coomb’s test.