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Case Report



Early Pathological Diagnosis for Earlier treatment: A case of Lupus Nephritis.

Jayashankar Chinnappa Anjanappa, Prakash Bhanu, Shalini A S, Ramya S S, Hari Bhargavi Battula, Sania Saba, Ishaq Mohammed, Amey Joshi.




Abstract
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Background: Lupus Nephritis is a common complication of Systemic Lupus Erythematosus (SLE) and is often associated with high mortality and morbidity. Prompt diagnosis and treatment is the keystone to managing this condition and has been found to significantly increase survival in patients.

Case presentation: We present a case of seropositive SLE which was complicated with Lupus Nephritis (LN). Our patient presented with a chronic history of maculopapular facial rash, hypertension and generalized oedema. On admission, she was investigated to have nephrotic range proteinuria with preserved kidney function. On the basis of high clinical suspicion of Lupus Nephritis, a renal biopsy was taken which revealed diffuse membranous glomerulonephritis. She responded well to immunosuppression therapies and Angiotensin-converting enzyme (ACE) inhibitors.

Conclusion: The decision to perform a renal biopsy in a patient with SLE can be made based on high clinical suspicion. Preserved kidney function through markers like normal estimated Glomerular filtration rate (eGFR) and Serum creatinine should not deter the healthcare provider from performing the renal biopsy. Early diagnosis of lupus nephritis can ensure earlier treatment intervention and can have better outcomes in terms of mortality and morbidity for the patient.

Key words: Keywords: Systemic Lupus Erythematosus, Lupus nephritis, Renal Biopsy






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