TY - JOUR T1 - Not all that is ‘full house’ is systemic lupus erythematosus: a case of membranous nephropathy due to syphilis infection JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2021-244466 VL - 14 IS - 8 SP - e244466 AU - Moira Marie Scaperotti AU - DongHyang Kwon AU - Bhaskar V Kallakury AU - Virginia Steen Y1 - 2021/08/01 UR - http://casereports.bmj.com/content/14/8/e244466.abstract N2 - We describe an unusual case of membranous nephropathy precipitated by syphilis infection in a patient without systemic lupus erythematosus (SLE). A previously healthy 20-year-old man presented with leg and facial swelling. Laboratory investigation revealed nephrotic range proteinuria, acute kidney injury, hypocomplementaemia and a highly positive rapid plasma reagin. Kidney biopsy showed membranous nephropathy with ‘full-house’ immunofluorescence (IgG, IgA, IgM, C1q and C3), mimicking lupus nephritis class Vb. However, the patient had no features of SLE and had negative antinuclear and anti-double-stranded DNA antibodies. He was treated with high-dose methylprednisolone and mycophenolate mofetil for lupus nephritis and with penicillin for syphilis. After 2 months of therapy, his proteinuria resolved, and his renal function and C4 level normalised. This case illustrates that syphilis infection can be a mimicker of lupus nephritis. A literature review suggests that ful-house nephropathy may occur independently of lupus nephritis and may or may not develop into SLE. ER -