Case Reports
Full House Nephropathy Without Serologic Markers: A Case Report
Main Article Content
Abstract
Full-house immunofluorescence pattern is most commonly a presentation of Lupus Nephritis. In the absence of characteristic serologic markers, determines a rare diagnostic and therapeutic challenge.
A fourteen-year-old female adolescent with sickle cell disease presented with nephrotic syndrome, pneumonia, empyema and arterial hypertension. The histopathology examination of kidney biopsy revealed a proliferative glomerulonephritis with a full-house pattern. Autoantibodies were negative, no complement consumption was detected and direct Coombs’ test was unremarkable. Other possible etiologies were ruled out. Remission was achieved with high dose corticosteroids and mycophenolate mofetil. All other Systemic Lupus Erythematosus clinical and laboratory criteria remained negative during the follow-up.
This case report aims to contribute to the awareness of a rare clinical entity, emphasizing the necessity of a correct treatment and a regular long-term follow-up.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Cameron JS. Lupus Nephritis. Journal of the American Society of Nephrology. 1999;10(2):413-424. doi:10.1681/ASN.V102413
Almutairi A, Aljammz H, Al-Hussain T, Al-Mayouf SM. Stand-alone renal SLICC criterion with full house glomerular deposits: is it enough for childhood lupus nephritis? Clinical Rheumatology. 2020;39(2):401-405. doi:10.1007/s10067-019-04789-7
Rijnink EC, Teng YKO, Kraaij T, Dekkers OM, Bruijn JA, Bajema IM. Validation of the Systemic Lupus International Collaborating Clinics classification criteria in a cohort of patients with full house glomerular deposits. Kidney International. 2018;93(1):214-220. doi:10.1016/j.kint.2017.07.017
Ruggiero B, Vivarelli M, Gianviti A, et al. Outcome of childhood-onset full-house nephropathy. Nephrology Dialysis Transplantation. 2016;32(7):gfw230. doi:10.1093/ndt/gfw230
Wen YK, Chen ML. Clinicopathological study of originally non-lupus “full-house” nephropathy. Renal Failure. 2010;32(9):1025-1030. doi:10.3109/0886022X.2010.510614
Rijnink EC, Teng YKO, Kraaij T, Wolterbeek R, Bruijn JA, Bajema IM. Idiopathic non-lupus full-house nephropathy is associated with poor renal outcome. Nephrology Dialysis Transplantation. 2017;32(4):654-662. doi:10.1093/ndt/gfx020
Markowitz GS, D’Agati VD. The ISN/RPS 2003 classification of lupus nephritis: An assessment at 3 years. Kidney International. 2007;71(6):491-495. doi:10.1038/sj.ki.5002118
Jennette JC, D’Agati VD, Olson JL, Silva FG. Heptinstall’s Pathology of the Kidney. 7th ed. Lippincott Williams & Wilkins; 2014.
Idris A, Abdulgayoom A, Mudawi E, el Hassan A, Elamin E, el Hassan LM. Coexistence of sickle cell nephropathy and lupus nephritis in a Sudanese child. Saudi Journal of Kidney Diseases and Transplantation. 2015;26(3):584. doi:10.4103/1319-2442.157397
Kanodia K v, Vanikar A v, Goplani KR, Gupta SB, Trivedi HL. Sickle cell nephropathy with diffuse proliferative lupus nephritis: a case report. Diagnostic Pathology. 2008;3(1):9. doi:10.1186/1746-1596-3-9
Tolaymat A, Mousily F al, MacWilliam K, Lammert N, Freeman B. Parvovirus glomerulonephritis in a patient with sickle cell disease. Pediatric Nephrology. 1999;13(4):340-342. doi:10.1007/s004670050622
Abeygunasekara SC, Peat D, Ross CN. Endocapillary glomerulonephritis secondary to human parvovirus B19 presenting with nephrotic syndrome: a report of two cases and a review of the literature. Renal Failure. 2010;32(7):880-883. doi:10.3109/0886022X.2010.494791
Groot N, de Graeff N, Avcin T, et al. European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative. Annals of the Rheumatic Diseases. 2017;76(11):1788-1796. doi:10.1136/annrheumdis-2016-210960
Lee Y, Woo JH, Choi S, Ji J, Song G. Induction and maintenance therapy for lupus nephritis: a systematic review and meta-analysis. Lupus. 2010;19(6):703-710. doi:10.1177/0961203309357763
Tunnicliffe DJ, Palmer SC. Immunosuppressive Treatment for Proliferative Lupus Nephritis: Summary of a Cochrane Review. American Journal of Kidney Diseases. 2018;72(5):756-757. doi:10.1053/j.ajkd.2018.07.008