Early-Onset Systemic Lupus Erythematosus Presenting as Membranous Lupus Nephritis in a 2-Year-Old Male: A Case Report

Abstract

Background: Lupus Nephritis (LN) is a severe manifestation of Systemic Lupus Erythematosus (SLE), which has a significant impact on morbidity and mortality. LN not often diagnosed before the age of 5 years and predominantly develops in girls. This case report adds to the limited literature on early-onset SLE presenting as membranous lupus nephritis in a 2-year-old male. Early recognition and intervention are crucial to preserve kidney function and improve outcomes. Timely management is critical for maintaining kidney function and preventing future complications. Case Presentation: We report a case of a 2-year-old Mexican male patient from a low-income region; autoimmune anemia and immune thrombocytopenia are the initial diagnoses. Despite treatment with prednisone and cyclosporine, we not observed response. In following days, we admitted the patient to our center with nephrotic-range proteinuria, hypertension and hematuria. Membranous lupus nephritis class V has identified by kidney biopsy. The diagnosis of membranous lupus nephritis in this young patient with clinical features of autoimmune disease highlighted the importance of considering SLE in all patients, regardless of age. The proposed treatment plan consisted of methylprednisolone and cyclophosphamide, which significantly improved the patient's condition. Conclusions: This case highlights the atypical presentation of SLE in a 2-year-old male and underscores the importance of maintaining a high degree of suspicion for SLE in young children. The rarity of SLE in this age group makes this case unique and emphasizes the need for early detection and intervention. By promptly diagnosing and treating SLE, we can improve outcomes and lower the chance of long-term complications, like chronic kidney disease. More investigation and case reporting are required in order to improve our comprehension of the unique clinical presentation and management of early-onset SLE.