A32-Year-Old Man Presented with Nephrotic Syndrome Due to Systemic Lupus Erythematosus Developed Lupus Cerebritis, Pancytopenia and Renal Failure: The Need for New Biologicals

Case SummaryA 32-year-old man presented with nephrotic syndrome due to membranous nephropathy, secondary to systemic lupus erythematosus (SLE). During intensive immunosuppressive therapy with corticosteroid and cyclophosphamide, the patient developed confusion, fits (lupus cerebritis), pancytopenia and rapidly rising serum creatinine (end stage renal failure). Plasmapheresis and rituximab therapy did not make improvement. Later, the patient had gastro-intestinal bleeding, ARDS secondary to bacterial pneumonia, fits andsuccumbed. Multiple cerebral hemorrhages, consolidation and bilateral small kidneys were found in autopsy.