A Case Report of Juvenile Systemic Lupus Erythematosus Presenting with Suspected Lupus Nephritis Flare: A Diagnostic and Therapeutic Challenge

Abstract

Background: Juvenile systemic lupus erythematosus (JSLE) is an autoimmune disease, in most cases major organ systems are involved and the lupus nephritis flares are the major contributors to morbidity. A quick diagnosis and early treatment are important in preventing long-term renal damage. Case Presentation: We present a 10-year-old female child, a case of a known juvenile case of SLE with history of nephritis since 2022 and presenting with sudden-onset abdominal distension, lack of appetite, nausea, low urine volume, abdominal pain, vomiting, fever, rashes, polyarthralgia, and melena. Laboratory investigations revealed leukopenia, anemia, hypoalbuminemia, increased ESR, 3+ proteinuria, high level of proteinuria 24 hours, and increasing urea levels. SLEDAI of 12 indicated flare and SLICE of 4+ indicated flare of lupus nephritis. She was treated using corticosteroids, diuretics, antibiotics, immunosuppressive therapy, and supportive therapy. She demonstrated progressive clinical and biochemical improvement, normalization of renal parameters by day nine and was discharged in stable condition. Conclusion: The case demonstrates the relevance of early recognition of the nephritis flares in JSLE and the efficiency of timely immunosuppressive treatment in eliminating the further worsening of the renal condition.