AN ASSORTED CASE SERIES OF LUPUS NEPHRITIS

P. V. Venkataramanappa, Dharani S.*, R. Sheeba and Giriraja K. V.

ABSTRACT

Introduction: Systemic lupus erythematosus (SLE) is an auto immune condition acquired due to the complicated processes underpinning the balance between immunological reactivity and immune tolerance. The disease progression varies in population across races and geographic distribution. An appalling complication is lupus nephritis (LN) with more than 40% prevalence. With time nearly 30% of patients progress to end-stage kidney disease (ESKD). We encountered three middle aged females with vivid presentation. First case was a mother of two kids presented with rashes and accelerated hypertension. Second case was a known case of cerebral venous thrombosis presented with frequent giddiness and blurring of vision. Third case presented with complaints of lower limb edema. On evaluation all three tested positive for ANA antibody and biopsy revealed stage IV lupus nephritis. They were treated with cyclophosphamide and immunomodulatory agents. However, one among them progressed to end stage renal disease requiring dialysis and succumbed. Conclusion: The disease per se presenting as LN is becoming more frequent. Hence, it is imperative for upcoming clinicians not to be oblivious as SLE manifestations are unusual. The disease progression is precipitous in few cases as in our study.

Keywords: Lupus nephritis, SLE, immune tolerance, female.