SCRIPT FOR LUPUS NEPHRITIS

Lupus Nephritis is considered a differential diagnosis due to the predominant

renal manifestations and coinciding laboratory results of the patient. Though the criteria
for SLE may not be fully established in the case of the patient, pediatric SLE usually has
an atypical presentation. Also according to Mina & Brunner (2010), lupus nephritis is the
presenting symptom in pediatric SLE. This is ruled in due to the presence of abdominal
enlargement and bipedal edema in pediatric lupus nephritis. According to Makker (2006),
though Anti-dsDNa antibodies are the most associated antibodies in lupus nephritis,
even in their absence, immune complexes of SLE can activate the complex pathway,
leading to hypocomplementenemia (low C3 levels). This may be useful in supporting the
diagnosis of lupus nephritis. Furthermore, according to McMillann (2006), proteinuria is a
sine qua non of lupus nephritis. Microscopic hematuria of the patient is also consistent.
In addition, lupus nephritis cannot be totally ruled out because not all present with
leukocytosis, normal BP, and low serum creatinine. Some may present otherwise.
Therefore, we decided that Lupus Nephritis could not be ruled out.