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Background: Lupus Nephritis (LN) is a severe manifestation of Systemic Lupus Erythematosus (SLE), which has a significant impact on morbidity and mortality. LN not often diagnosed before the age of 5 years and predominantly develops in girls. This case report adds to the limited literature on early-onset SLE presenting as membranous lupus nephritis in a 2-year-old male. Early recognition and intervention are crucial to preserve kidney function and improve outcomes. Timely management is critical for maintaining kidney function and preventing future complications. Case Presentation: We report a case of a 2-year-old Mexican male patient from a low-income region; autoimmune anemia and immune thrombocytopenia are the initial diagnoses. Despite treatment with prednisone and cyclosporine, we not observed response. In following days, we admitted the patient to our center with nephrotic-range proteinuria, hypertension and hematuria. Membranous lupus nephritis class V has identified by kidney biopsy. The diagnosis of membranous lupus nephritis in this young patient with clinical features of autoimmune disease highlighted the importance of considering SLE in all patients, regardless of age. The proposed treatment plan consisted of methylprednisolone and cyclophosphamide, which significantly improved the patient's condition. Conclusions: This case highlights the atypical presentation of SLE in a 2-year-old male and underscores the importance of maintaining a high degree of suspicion for SLE in young children. The rarity of SLE in this age group makes this case unique and emphasizes the need for early detection and intervention. By promptly diagnosing and treating SLE, we can improve outcomes and lower the chance of long-term complications, like chronic kidney disease. More investigation and case reporting are required in order to improve our comprehension of the unique clinical presentation and management of early-onset SLE.
Background: Lupus Nephritis (LN) is a severe manifestation of Systemic Lupus Erythematosus (SLE), which has a significant impact on morbidity and mortality. LN not often diagnosed before the age of 5 years and predominantly develops in girls. This case report adds to the limited literature on early-onset SLE presenting as membranous lupus nephritis in a 2-year-old male. Early recognition and intervention are crucial to preserve kidney function and improve outcomes. Timely management is critical for maintaining kidney function and preventing future complications. Case Presentation: We report a case of a 2-year-old Mexican male patient from a low-income region; autoimmune anemia and immune thrombocytopenia are the initial diagnoses. Despite treatment with prednisone and cyclosporine, we not observed response. In following days, we admitted the patient to our center with nephrotic-range proteinuria, hypertension and hematuria. Membranous lupus nephritis class V has identified by kidney biopsy. The diagnosis of membranous lupus nephritis in this young patient with clinical features of autoimmune disease highlighted the importance of considering SLE in all patients, regardless of age. The proposed treatment plan consisted of methylprednisolone and cyclophosphamide, which significantly improved the patient's condition. Conclusions: This case highlights the atypical presentation of SLE in a 2-year-old male and underscores the importance of maintaining a high degree of suspicion for SLE in young children. The rarity of SLE in this age group makes this case unique and emphasizes the need for early detection and intervention. By promptly diagnosing and treating SLE, we can improve outcomes and lower the chance of long-term complications, like chronic kidney disease. More investigation and case reporting are required in order to improve our comprehension of the unique clinical presentation and management of early-onset SLE.
Background: Lupus nephritis (LN) is an inflammation of the kidneys that is related to systemic lupus erythematosus (SLE). This study aimed to evaluate the differences in clinical and laboratory characteristics between LN and non-LN SLE patients. Methods: We conducted a retrospective analysis of medical records collected from SLE patients treated at the University Hospital in Kraków, Poland, from 2012 to 2022. All patients met the 2019 European League Against Rheumatism and the American College of Rheumatology (EULAR/ACR) criteria for SLE. Results: Among 921 SLE patients, LN was documented in 331 (35.94%). LN patients were younger at SLE diagnosis (29 vs. 37 years; p < 0.001) and had a male proportion that was 2.09 times higher than the non-LN group (16.62% vs. 7.97%; p < 0.001). They were more often diagnosed with serositis and hematological or neurological involvement (p < 0.001 for all). Hypertension and hypercholesterolemia occurred more frequently in these patients (p < 0.001 for both). LN patients exhibited a higher frequency of anti-dsDNA, anti-histone, and anti-nucleosome antibodies (p < 0.001 for all). Conversely, the non-LN group had a 1.24-fold (95% CI: 1.03–1.50; p = 0.021) increase in the odds ratio of having positive anti-cardiolipin IgM antibody results. LN patients were more frequently treated with immunosuppressants. The risk factors for experiencing at least three LN flares included female sex, younger age at the onset of LN or SLE, LN occurring later than SLE onset, the presence of anti-nucleosome or anti-dsDNA antibodies, and certain SLE manifestations such as myalgia, arthritis, proteinuria > 3.5 g/day, and pathological urinary casts in the urine sediment. Conclusions: LN patients differ from non-LN patients in the age of SLE diagnosis, treatment modalities, and autoantibody profile and have more frequent, severe manifestations of SLE. However, we still need more prospective studies to understand the diversity of LN and its progression in SLE patients.
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