Document Type : case report
Authors
- Neda Ghorbani-khosroshahi 1
- Vadood Javadi 2
- Fatemeh Nili 3
- Hananeh Gholamali-Majdabadi 4
- Masoumeh Mohkam 1
- Ghazal Azad 4
1 Pediatric Nephrology Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Pediatric Rheumatologist, Pediatric Pathology Research Center, Mofid Children's Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of pathology, Cancer Institute, Imam Khomeini Hospital complex, Tehran university of medical sciences
4 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Background: Lupus nephritis (LN) is a serious renal complication of systemic lupus erythematosus (SLE), particularly in the pediatric population. It commonly presents with persistent hematuria and proteinuria, which can overlap with other glomerular disorders. This case report highlights the diagnostic challenges associated with LN in the presence of nonspecific clinical features.
Case presentation: A 4-year-old boy was admitted for evaluation of persistent recurrent gross hematuria, which continued despite previous surgery for suspected urethral stricture. Initial laboratory tests revealed significant hematuria, proteinuria, and mildly elevated inflammatory markers, raising concerns for nephritis. The patient was initially diagnosed with post-streptococcal glomerulonephritis (PSGN), but this was later excluded. A renal biopsy revealed membranous glomerulonephritis (MGN) stage I-II, and further immunological testing, including ANA and anti-dsDNA antibodies, led to the final diagnosis of lupus nephritis class V. The findings were consistent with systemic lupus erythematosus, confirming the diagnosis.
Conclusion: We report a pediatric patient diagnosed with Class V lupus nephritis based on renal biopsy, presenting with recurrent hematuria. This case emphasizes the importance of early nephrology consultation, serial testing, and renal biopsy to ensure accurate diagnosis and appropriate management.
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