New Diagnosis of Lupus Nephritis in the Third Trimester-A Case Report.

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.