Pediatric lupus nephritis presenting with terminal renal failure

Martine T. P. Besouw*, Johan G. Vande Walle, Mohamad I. Ilias, Ann M. Raes, Agnieszka A. Prytula, Lieve Claeys, Jo L. Dehoorne

*Corresponding author for this work

Research output: Book/ReportReportProfessional

3 Citations (Scopus)

Abstract

A 12-year-old Congolese girl presented with acute renal failure, edema, hypertension, hemoptysis, hematuria, and proteinuria after a history of throat infection. Renal ultrasound showed kidneys of normal size, with increased echogenicity of the cortical parenchyma and decreased corticomedullary differentiation. Other additional investigations showed pancytopenia with decreased complement (low C3 and C4). Antinuclear antibodies were strongly positive, including anti-double stranded DNA. Renal biopsy confirmed severe grade IV lupus nephritis. She was treated with high-dose steroids, mycophenolate mofetil and hydroxychloroquine, in addition to hemodialysis. After oneweek of intensive treatment, diuresis recovered and dialysis could be stopped after six sessions. We describe an uncommon case of severe lupus nephritis, presenting with terminal renal failure. Since the rarity of this disease presentation, other more common diagnoses have to be considered. Once the diagnosis of lupus nephritis is established, a choice has to be made between the different induction treatment protocols. The patient's ethnic background and other supportive therapies, such as the need for dialysis, can help to make this choice.

Original languageEnglish
Number of pages3
Volume71
Edition6
DOIs
Publication statusPublished - Dec-2016

Publication series

NameActa clinica belgica
PublisherTaylor & Francis Ltd
ISSN (Print)1784-3286

Keywords

  • Systemic lupus erythematosus
  • Lupus nephritis
  • Acute renal failure
  • Terminal renal failure
  • Dialysis
  • Differential diagnosis

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