Is there a role for eculizumab in the management of refractory lupus nephritis?  

There is no evidence of eculizumab as a treatment for lupus nephritis, yet it might be considered if complement-mediated TMA presents even as a result of SLE as a trigger if direct treatment of SLE fails to achieve clinical goals.

This is currently being evaluated. There is a study of ravulizumab in patients with lupus nephritis or IgA nephropathy (basket trial).

A couple of older references. I think you HAVE to think outside of the box when you have refractory ANYTHING. My opinion...  Sciascia et al., PMID 28258475 Pickering et al., PMID 26316577