Diabetic nephropathy and end-stage renal disease in a 28-year-old woman, or is it?

A 28-year-old Hispanic woman presented to the emergency department with pneumonia and bilateral pulmonary oedema, requiring admission to the intensive care unit. Additional history included type 1 diabetes mellitus, End Stage Renal Disease on haemodialysis and Hashimoto's disease. On further diagnostic evaluation, she was found to have systemic lupus erythematosus (SLE) with overlap syndrome.