1The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Childrens Hospital 2The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Childrens Hospital 3The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Childrens Hospital 4The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Childrens Hospital 5The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Childrens Hospital 6The Institute of Kidney Disease, Department of Pathology, Yonsei University College of Medicine, Severance Childrens Hospital 7The Institute of Kidney Disease, Department of Pathology, Yonsei University College of Medicine, Severance Childrens Hospital
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ABSTRACT
A 16-year-old girl presented with proteinuria and microscopic hematuria detected through mass urinary screening and was diagnosed as having suspected postinfectious glomerulonephritis by renal biopsy. However, heavy proteinuria did not respond to angiotensin converting enzyme inhibitor therapy. After 6 months, cervical lymphadenitis developed and a neck node biopsy showed subacute necrotizing lymphadenitis. After an additional 2 months, she developed facial erythema and thrombocytopenia. A repeat renal biopsy demonstrated lupus nephritis class IV. She was treated with pulse methylprednisolone(500 mg/day intravenously for 3 consecutive days) followed by oral deflazacort and monthly intravenous cyclophosphamide pulse(1 g/$m^2$) for 6 months. We report a case diagnosed as systemic lupus erythematosus(SLE) during medical follow-up after urinary screening.
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