Full-House Nephropathy in Antinuclear Antibody-Negative Systemic Lupus Erythematosus: A Case Report

July 2024 in “ Clinical Case Reports ”

Reechashree Dhungana, Bibhav Bashyal, Sagar Paudel, Bibek Man Shrestha, Saket Jha, Nishan Bhurtyal

systemic lupus erythematosus lupus nephritis malar rash photosensitivity hair loss methylprednisolone mycophenolate mofetil SLE steroid CellCept

TLDR ANA-negative lupus nephritis can be diagnosed and treated effectively with a comprehensive approach.

This case report describes a 25-year-old female with antinuclear antibody (ANA)-negative systemic lupus erythematosus (SLE) who developed class IV lupus nephritis with full-house nephropathy. Despite negative serological markers, clinical symptoms such as malar rash, photosensitivity, hair loss, and renal impairment led to a strong suspicion of SLE. Treatment with methylprednisolone and mycophenolate mofetil improved her condition. The report highlights the diagnostic challenges of ANA-negative SLE, emphasizing the importance of clinical judgment and the need for distinct guidelines and inclusion of ANA-negative cases in clinical trials to better understand SLE's heterogeneity.

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