Leaky gut and silent kidneys – a challenging presentation in systemic lupus erythematosus – What, Why and How? (Eng)

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease predominantly affecting young females. Its presentation varies from mild musculoskeletal, muco-cutaneous involvement to life and organ threatening manifestations like renal failure, diffuse alveolar haemorrhage, hemophagocytic lymphohistiocytosis (HLH) and organic brain syndrome. Even though it is a female predominant disease, males tend to be higher severity, more renal involvement, higher mortality and delay in diagnosis. Acute presentation of gastroenteritis with renal failure have differentials like infections causing pre-renal azotemia, hemolytic uremic syndrome, systemic vasculitis and certain toxins, poisonings or drugs. We present case of a young male with diarrhea and acute renal failure, later diagnosed and managed as systemic lupus erythematosus.