Biopsy-Confirmed Lupus Nephritis with Advanced Sclerosing Disease Managed with Overlap Treatment. A Case Report
DOI:
https://doi.org/10.60787/tnhj.v24i2.828Keywords:
case report, lupus nephritis, remission, relapse, histology, haemodialysis, kidney biopsy, systemic lupus erythematosusAbstract
Background: Lupus nephritis, complicating systemic lupus erythematosus, can progress to end-stage kidney disease, with a poor prognosis. Histological diagnosis is essential in formulating an effective treatment regimen particularly with symptom overlap.
Method: We highlighted the role of a histological diagnosis in the management of Lupus nephritis with complex overlapping symptoms according to approved treatment protocol.
Result: She was anemic and the histological diagnosis was class VI lupus nephritis. She was managed using an overlapping treatment spanning classes IV – VI, with haemodialysis (HD), mycophenolate mofetil, methylprednisolone and diuretics based on heightened disease activity and extrarenal manifestations. Using the WHO and the International Society of Nephrology/Renal Pathology Society revised guidelines, KDIGO recommended haemodialysis for classes III, IV, and V with nephrotic syndrome, in addition to high dose corticosteroids, cyclophosphamide/MMF (induction therapy), and low dose corticosteroid/MMF for maintenance therapy. The disease went into remission, and she continued outpatient HD.
Conclusion: The case highlights the place of histological diagnosis in managing LN associated with complexities of staging and symptoms-overlap to achieve optimal results.
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