Pathmanathan Umesha, Sivakumaran Sivasaaini, Eccles-Smith Jade, Craven Ann-Maree, Smith Jill Parkes, Puri Prianka, Hepburn Kirsten
Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Australia.
School of Medicine and Dentistry, Griffith University, Brisbane, Australia.
Nephrology (Carlton). 2025 May;30(5):e70037. doi: 10.1111/nep.70037.
New-onset lupus nephritis (LN) poses a diagnostic and management challenge during pregnancy. This is more pertinent in the indigenous population, where the prevalence is higher, and the clinical phenotype tends to be more severe. We report the case of a 30-year-old G3P2 indigenous female, living in remote Queensland, with a late presentation of nephrotic syndrome at 30 weeks gestation. A clinical diagnosis of Class V LN was made without a kidney biopsy due to maternal and foetal risk, and she was empirically treated with steroids and disease-modifying agents to good effect. She remained normotensive with appropriate foetal growth and delivered a healthy male infant at 37 weeks. A renal biopsy taken 9 weeks after commencement of therapy demonstrated Class II LN, likely representing a resolving flare in the presence of improved clinical symptoms.
新发狼疮性肾炎（LN）在孕期的诊断和管理方面存在挑战。这在原住民群体中更为突出，该群体中LN患病率更高，且临床表型往往更严重。我们报告了一例30岁、孕3产2的原住民女性病例，她居住在昆士兰偏远地区，在妊娠30周时出现肾病综合征且就诊较晚。由于存在母婴风险，未进行肾活检即临床诊断为Ⅴ类LN，经验性给予类固醇和改善病情药物治疗，效果良好。她血压一直正常，胎儿生长正常，37周时顺产一名健康男婴。治疗开始9周后进行的肾活检显示为Ⅱ类LN，可能代表在临床症状改善的情况下病情缓解中的发作。
