Childhood-onset systemic lupus erythematosus with lupus nephritis in a 38-month-old Nigerian Child– a case report

Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic multi-systemic autoimmune disease that is difficult to diagnose due to the varied clinical presentations. A high index of suspicion is required for early detection in childhood because it presents a more severe disease with a poorer prognosis compared to adults. Occurrence below five years is rare and occurs more in non-Caucasians. Lupus nephritis is one of the most severe manifestations of SLE in children and a major risk factor for morbidity and mortality.

Case presentation: We present a 38-month-old girl with more than four documented diagnostic criteria for SLE. Renal histology showed features in keeping with Class IIIA ISN classification. She responded to pulse methylprednisolone/oral corticosteroid-mycophenolate mofetil therapy and is in remission.

Discussion/Conclusion: From our literature review, our patient is the first reported youngest case of SLE with lupus nephritis in Southern Nigeria. The condition should be suspected in young children presenting with bizarre multi-systemic manifestations. Survival in our setting largely depends on accessibility to diagnostic facilities and the availability of funds to manage the disease.