Authors :
Dr. Ishana Gaur
Volume/Issue :
Volume 9 - 2024, Issue 9 - September
Google Scholar :
https://tinyurl.com/mr3jvpen
Scribd :
https://tinyurl.com/2yy9cur6
DOI :
https://doi.org/10.38124/ijisrt/IJISRT24SEP1227
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Background
Systemic Lupus Erythematosus (SLE) is a chronic
autoimmune disorder with multi-organ involvement,
particularly affecting the kidneys in the form of lupus
nephritis. Lupus nephritis is a severe complication of SLE
and is a leading cause of morbidity and mortality in these
patients. The disease primarily affects young adults and is
characterized by proteinuria, hematuria, and kidney
dysfunction. Early diagnosis and timely treatment are
crucial in preventing progression to end-stage renal
disease.
Case Report
A 32-year-old female presented with a three-month
history of skin rashes, hair loss, oral ulcers, and joint pain,
followed by the development of edema, generalized
weakness, and frothy urine. Physical examination revealed
significant pitting edema, ascites, and pleural effusion.
Laboratory investigations showed anemia,
hypoalbuminemia, hypercholesterolemia, elevated
inflammatory markers, and proteinuria in the nephrotic
range. Autoimmune markers were positive for ANA,
dsDNA, and other lupus-associated antibodies. Renal
ultrasound revealed increased cortical echogenicity, and a
kidney biopsy confirmed membranous lupus nephritis
(ISN/RPS Class V). The patient was started on high-dose
corticosteroids and cyclophosphamide for induction
therapy, followed by a maintenance regimen. Her
condition improved significantly, with proteinuria reduced
to less than 0.5 grams/24 hours, and her edema resolved.
Conclusion
This case emphasizes the importance of early
recognition and treatment of lupus nephritis in patients
with SLE to prevent irreversible kidney damage. The
patient's favorable response to timely immunosuppressive
therapy highlights the critical role of aggressive treatment
in controlling disease activity and improving outcomes.
Regular follow-up and monitoring are essential to ensure
long-term disease control and prevent relapses.
Keywords :
Systemic Lupus Erythematosus (SLE) , Lupus nephritis, Membranous nephropathy, Renal biopsy, Nephrotic syndrome, ANA positivity, dsDNA antibodies, ISN/RPS classification
References :
- Tselios, K., & Gladman, D. D. (2021). Systemic lupus erythematosus: An overview of clinical manifestations. Journal of Autoimmunity, 116, 102568.
- Doria, A., & Ghirardello, A. (2019). Lupus nephritis: Pathogenesis and treatment. Nature Reviews Nephrology, 15(1), 61-73.
- Drenkard, C., & Alarcón-Segovia, D. (2017). Lupus nephritis: An update. Clinical Rheumatology, 36(3), 477-490.
- Gatto, M., & Tincani, A. (2020). Update on lupus nephritis. Nature Reviews Nephrology, 16(1), 10-22.
- Houssiau, F. A., & D'Cruz, D. P. (2018). Lupus nephritis: Pathophysiology, clinical presentation, and management. Nature Reviews Nephrology, 14(10), 635-652.
- Appel, G. B., & Waldman, M. (2018). The importance of early diagnosis and treatment of lupus nephritis. American Journal of Kidney Diseases, 72(5), 718-724.
- Bertsias, G., & Ioannidis, J. P. (2018). EULAR recommendations for the management of systemic lupus erythematosus. Annals of the Rheumatic Diseases, 77(3), 394-405.
- Chan, T. M., & Tang, S. C. (2021). Treatment of lupus nephritis: A critical review. Clinical Journal of the American Society of Nephrology, 16(5), 709-719.
- Gharavi, A. E., & Khamashta, M. A. (2020). The role of autoantibodies in the diagnosis and management of lupus nephritis. Journal of Autoimmunity, 110, 102429.
- Fok, M. J., & Liu, X. (2021). Lupus nephritis: A review of the current management strategies. Current Opinion in Rheumatology, 33(6), 580-587.
Background
Systemic Lupus Erythematosus (SLE) is a chronic
autoimmune disorder with multi-organ involvement,
particularly affecting the kidneys in the form of lupus
nephritis. Lupus nephritis is a severe complication of SLE
and is a leading cause of morbidity and mortality in these
patients. The disease primarily affects young adults and is
characterized by proteinuria, hematuria, and kidney
dysfunction. Early diagnosis and timely treatment are
crucial in preventing progression to end-stage renal
disease.
Case Report
A 32-year-old female presented with a three-month
history of skin rashes, hair loss, oral ulcers, and joint pain,
followed by the development of edema, generalized
weakness, and frothy urine. Physical examination revealed
significant pitting edema, ascites, and pleural effusion.
Laboratory investigations showed anemia,
hypoalbuminemia, hypercholesterolemia, elevated
inflammatory markers, and proteinuria in the nephrotic
range. Autoimmune markers were positive for ANA,
dsDNA, and other lupus-associated antibodies. Renal
ultrasound revealed increased cortical echogenicity, and a
kidney biopsy confirmed membranous lupus nephritis
(ISN/RPS Class V). The patient was started on high-dose
corticosteroids and cyclophosphamide for induction
therapy, followed by a maintenance regimen. Her
condition improved significantly, with proteinuria reduced
to less than 0.5 grams/24 hours, and her edema resolved.
Conclusion
This case emphasizes the importance of early
recognition and treatment of lupus nephritis in patients
with SLE to prevent irreversible kidney damage. The
patient's favorable response to timely immunosuppressive
therapy highlights the critical role of aggressive treatment
in controlling disease activity and improving outcomes.
Regular follow-up and monitoring are essential to ensure
long-term disease control and prevent relapses.
Keywords :
Systemic Lupus Erythematosus (SLE) , Lupus nephritis, Membranous nephropathy, Renal biopsy, Nephrotic syndrome, ANA positivity, dsDNA antibodies, ISN/RPS classification