ABSTRACT Lupus nephritis is a severe manifestation of systemic lupus erythematosus (SLE) typically characterized by glomerular “full‐house” immunofluorescence. However, non‐lupus nephropathies may occasionally exhibit similar patterns, creating diagnostic uncertainty. Non‐lupus full‐house nephropathy (FHN) is a recently recognized entity in which a full‐house immunofluorescence pattern occurs in the absence of serological or clinical evidence of SLE. We report a 4‐year‐old girl who presented with generalized edema, hematuria, hypertension, and nephrotic‐range proteinuria. Laboratory evaluation revealed anemia, elevated serum creatinine, and low complement C3 levels but negative antinuclear antibody (ANA) and anti‐double‐stranded DNA (anti‐dsDNA) tests. Renal biopsy demonstrated diffuse proliferative glomerulonephritis consistent with lupus nephritis Class IV, with full‐house immunofluorescence positivity for IgG, IgA, IgM, C3, and C1q. In the absence of systemic or serologic lupus features, a diagnosis of non‐lupus full‐house nephropathy was made. The patient was treated with pulse methylprednisolone followed by oral prednisolone, monthly cyclophosphamide for 6 months, and maintenance therapy with azathioprine and low‐dose steroids. Hydroxychloroquine and antihypertensive agents were added. She achieved clinical and biochemical remission on follow‐up.
Anjum et al. (Sun,) studied this question.