Systemic lupus erythematosus in an adolescent Nigerian girl presenting as nephrotic syndrome.

Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect various organ systems, including the kidneys. Lupus nephritis (LN) is a major complication of SLE and can significantly impact the patient's prognosis. 

Case report: We present the case of a 17-year-old girl diagnosed with LN class III+V. She presented with generalized body swelling, fatigue and reduced appetite. Laboratory investigations revealed proteinuria 3+, hematuria 2+, elevated antinuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA) antibodies, and decreased complement levels, consistent with a diagnosis of SLE. A kidney biopsy confirmed the diagnosis of LN class III+V. She responded to high dose methyl prednisolone, hydroxychloroquine and treatment, with a significant reduction in proteinuria and improvement in renal function. The patient is currently being closely monitored for any disease flare-ups or adverse effects of the medications.

Discussion: This case highlights the importance of early recognition and appropriate management of LN in adolescent patients with features of NS. The combination of corticosteroids and MMF has shown promising results in the treatment of this complex condition. Ongoing monitoring and a multidisciplinary approach are essential for the successful management of LN in this patient population.