Full-house nephropathy in a patient with negative serology for lupus.
A 10-year-old girl presented with a complaint of recurrent abdominal pain. Physical examination findings were unremarkable. Laboratory investigations revealed BUN of 17 mg/dl and creatinine of 1 mg/dl, and complement levels were normal. She had neither hematuria nor proteinuria, and glomerular filtration rate was 60.9 ml/min/1.73 m(2). ANA, anti-DNA, p-ANCA and c-ANCA were all negative. Renal biopsy revealed findings of class III lupus nephritis in light, "full-house" nephropathy in immune fluorescent and tubuloreticular inclusions in electron microscopic examinations. After 17 months of treatment, her last creatinine is 2.5 mg/dl and GFR is 17.9 ml/min/1.73 m(2) and ANA and anti-DNA remain still negative. This case presents an example that decreased GFR can be the first presenting symptom of full-house nephropathy. Those patients who have negative lupus serology and renal biopsy findings of full-house nephropathy and tubuloreticular inclusions may behave and should be treated as lupus nephritis.
Baskin
Esra
E
Department of Pediatric Nephrology, Baskent University, 6, Cadde No: 72/3, O6490, Bahcelievler, Ankara, Turkey. esrabaskin@yahoo.com
Agras
Pinar Isik
PI
Menekşe
Nurcan
N
Ozdemir
Handan
H
Cengiz
Nurcan
N
D002648:Child; D005260:Female; D005919:Glomerular Filtration Rate / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007668:Kidney / Q000473:pathology*; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis; D008181:Lupus Nephritis / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology*; D008856:Microscopy, Fluorescence
D007136:Immunoglobulins