Diagnosis of Systemic Lupus Erythematosus During Medical Follow-up After Urinary Screening

Yoon, So-Jin; Song, Ji-Eun; Shin, Jae-Il; Jeong, Il-Cheon; Lee, Jae-Seung; Shim, Hyo-Sup; Jeong, Hyeon-Joo

doi:2008.12.2.227

J Korean Soc Pediatr Nephrol > Volume 12(2); 2008 > Article

J Korean Soc Pediatr Nephrol 2008;12(2): 227-232. doi: https://doi.org/10.3339/jkspn.2008.12.2.227

학교 집단 요 검사 이상으로 추적검사 중 전신 홍반 루푸스로 진단된 1예

윤소진, 송지은, 신재일, 정일천, 이재승, 심효섭, 정현주

¹연세대학교 의과대학 소아과학교실
²연세대학교 의과대학 소아과학교실
³연세대학교 의과대학 소아과학교실
⁴연세대학교 의과대학 소아과학교실
⁵연세대학교 의과대학 소아과학교실
⁶연세대학교 의과대학 병리학교실
⁷연세대학교 의과대학 병리학교실

Diagnosis of Systemic Lupus Erythematosus During Medical Follow-up After Urinary Screening

So-Jin Yoon, Ji-Eun Song, Jae-Il Shin, Il-Cheon Jeong, Jae-Seung Lee, Hyo-Sup Shim, Hyeon-Joo Jeong

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

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.

Key words: Systemic lupus erythematosus(SLE) | Lupus nephritis(LN)