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Systemic lupus erythematosus nephritis — RACP Paediatrics MCQ

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HardRheumatology and dermatologySystemic lupus erythematosus nephritisRACP Paediatrics

A 13-year-old girl has fatigue, photosensitive rash and ankle swelling. Urinalysis shows blood and protein, creatinine is elevated, complements are low and anti-dsDNA is positive. What is the most appropriate investigation?

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Correct answer: B — Urine protein quantification and renal biopsy planning with nephrology

SLE with haematuria, proteinuria, low complement and rising creatinine suggests lupus nephritis; quantification and renal biopsy guide immunosuppressive treatment. Topical therapy alone misses potentially organ-threatening disease. The pearl is that renal involvement in paediatric SLE may be clinically subtle but prognostically important.

Reference: RCH Clinical Practice Guidelines; Therapeutic Guidelines (eTG): Rheumatology