Lupus nephritis mimicking pyelonephritis in pregnancy.

Background Systemic lupus erythematosis (SLE) is a multisystemic autoimmune connective tissue disorder that presents with a wide range of clinical manifesta tons including renal involvement Routine prenatal care includes assessment of renal function Case A 29 year old nullipara presented at 17 weeks with fever, vomiting, and costovertebral angle tenderness 1 week after being treated for a presumed urinary tract infection On presentation new onset hypertension was noted Inpatient evaluation established a diagnosis of SLE with lupus nephritis The pregnancy ended with intrauterine fetal demise Conclusion SLE is a disease with complex and protean clinical manifestations It should appear on the differential when more common disease processes are ruled out Routine prenatal care can detect otherwise silent and undiagnosed renal disease, and with early intervention improve prognosis