Results:
The patient remained hospitalized for 46 days; throughout this period, clinical and hemodynamic stability was achieved, accompanied by normalization of laboratory parameters, including Complete Blood Count (CBC), renal function tests, liver function tests, and pancreatic enzymes (Table 1).
Subsequently, on day 46 of hospital admission, the patient was planned to be discharged. On discharge, it was planned to give monthly IV cyclophosphamide for total 6 cycle and continued oral prednisolone with a gradual tapering schedule as per KDIGO 2024 clinical practice guideline for the management of lupus nephritis, along with oral hydroxychloroquine, zinc sulphate, antihypertensives, hematinic, calcium, and multivitamins.
Over the following three months of outpatient follow-up, serum ceruloplasmin and urinary copper levels were normalized (Table 1); ophthalmological evaluation yielded normal findings, and the child successfully returned to school.