The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report

Tomasz Koszutski; Agnieszka Wiernik; Lidia Hyla-Klekot; Natalia Matysiak; Grażyna Kucharska

doi:10.5114/ceji.2022.117828

eISSN: 1644-4124
ISSN: 1426-3912

Central European Journal of Immunology

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2/2022
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abstract:

Case report

The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report

Tomasz Koszutski

¹

,

Agnieszka Wiernik

¹

,

Lidia Hyla-Klekot

¹

,

Natalia Matysiak

²

,

Grażyna Kucharska

³

Department of Pediatric Surgery and Urology, Medical University of Silesia, Katowice, Poland
Department of Histology and Embryology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
Department of Pediatric Nephrology, Team of Municipal Hospitals in Chorzów, Poland

Cent Eur J Immunol 2022; 47 (2): 175-180

DOI: https://doi.org/10.5114/ceji.2022.117828

Online publish date: 2022/07/04

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AMA

Koszutski T, Wiernik A, Hyla-Klekot L, Matysiak N, Kucharska G. The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report. Central European Journal of Immunology. 2022;47(2):175-178. doi:10.5114/ceji.2022.117828.

APA

Koszutski, T., Wiernik, A., Hyla-Klekot, L., Matysiak, N.,  & Kucharska, G. (2022). The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report. Central European Journal of Immunology, 47(2), 175-178. https://doi.org/10.5114/ceji.2022.117828

Chicago

Koszutski, Tomasz, Agnieszka Wiernik, Lidia Hyla-Klekot, Natalia Matysiak,  and Grażyna Kucharska. 2022. "The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report". Central European Journal of Immunology 47 (2): 175-178. doi:10.5114/ceji.2022.117828.

Harvard

Koszutski, T., Wiernik, A., Hyla-Klekot, L., Matysiak, N.,  and Kucharska, G. (2022). The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report. Central European Journal of Immunology, 47(2), pp.175-178. https://doi.org/10.5114/ceji.2022.117828

MLA

Koszutski, Tomasz et al. "The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report." Central European Journal of Immunology, vol. 47, no. 2, 2022, pp. 175-178. doi:10.5114/ceji.2022.117828.

Vancouver

Koszutski T, Wiernik A, Hyla-Klekot L, Matysiak N, Kucharska G. The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report. Central European Journal of Immunology. 2022;47(2):175-178. doi:10.5114/ceji.2022.117828.

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The course of juvenile-onset systemic lupus erythematosus may vary, from rapid multiorgan involvement to insidious development mimicking different medical conditions. Depressive disorder in adolescents poses considerable diagnostic difficulties due to the natural tendency to lowered mood in this age group. However, it may also be the manifestation of a systemic disease. We present a case of a 16-year-old female patient without any somatic symptoms in whom severe depression resistant to treatment was the preceding symptom of juvenile-onset systemic lupus erythematosus (jSLE). Because of isolated proteinuria and presence of antinuclear antibodies, renal biopsy was performed. Light microscopy showed only findings characteristic for membranous nephropathy. Examination on electron microscopy showed characteristic tubuloreticular inclusions (TRIs) which were crucial for making the diagnosis of systemic lupus erythematosus. The evaluation of renal biopsy specimens by electron microscopy could be a useful diagnostic step to confirm the diagnosis, especially in difficult cases where the criteria for SLE are not fully met. The association of mental symptoms with systemic lupus erythematosus and other autoimmune disorders is well documented. However, the increasing prevalence of depression in children and adolescents poses a risk of delaying the diagnosis of a systemic disease.

keywords:

The role of assessment of renal biopsy in electron microscopy in making a diagnosis of juvenile-onset systemic lupus erythematosus in a 16-year-old female patient with depression and proteinuria – case report

Tomasz Koszutski 1 , Agnieszka Wiernik 1 , Lidia Hyla-Klekot 1 , Natalia Matysiak 2 , Grażyna Kucharska 3

juvenile-onset systemic lupus erythematosus, depression, tubuloreticular inclusions, TRIs, lupus nephritis

Tomasz Koszutski

¹

,

Agnieszka Wiernik

¹

,

Lidia Hyla-Klekot

¹

,

Natalia Matysiak

²

,

Grażyna Kucharska

³