Lupus nephritis in a child with AIDS

Concomitant acquired Immunodeficiency syndrome (AIDS) and lupus nephritis I s an exceptional feature In white patients. A white boy with maternofetal h uman Immunodeficiency virus (HIV) Infection had no medical follow-up until he presented at 12 years of age with a nephrotic syndrome, macrohematuria, renal failure, pancytopenia, and low CD4+ cell count. A renal biopsy reveal ed severe lupus nephritis (World Health Organization class IV) with specifi c immune deposits in the absence of any clinical sign of systemic lupus ery thematosus or specific autoantibodies at the time of diagnosis. The treatme nt consisted of methylprednisolone, pulses followed by oral prednisone; ant iretroviral triple therapy was started a few weeks later, which contributed to clinical and biologic Improvement. To our knowledge, this Is the first case report of lupus-like nephritis In a white child with AIDS, whose outco me might be Improved significantly by a combination of steroids and antiret roviral therapy. (C) 2001 by the National Kidney Foundation, Inc.