An Integrative Homeopathic Approach in the Management of Class II Mesangial Lupus Nephritis: A Case Report

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with frequent renal involvement that significantly influences disease prognosis. Class II mesangial lupus nephritis represents an early histopathological stage and may present with persistent proteinuria and recurrent disease flares. Conventional long-term management often requires prolonged corticosteroid and immunosuppressive therapy, which may lead to adverse effects and therapeutic dependency.

A 20-year-old male with SLE and biopsy-proven Class II mesangial lupus nephritis presented with recurrent febrile episodes, fatigue, weight loss, thrombocytopenia and persistent proteinuria, despite extended treatment with corticosteroids, mycophenolate mofetil and hydroxychloroquine. Individualized homeopathic treatment was initiated in February 2022 following a comprehensive constitutional assessment. Lycopodium clavatum was prescribed as the principal remedy, with Serum anguillae used supportively during periods of urinary involvement, in accordance with classical homeopathic principles. The patient was followed clinically and through periodic laboratory investigations for over 3 years.

During follow-up, the frequency and intensity of febrile episodes gradually declined, with improvement in appetite, body weight and overall well-being. Laboratory findings demonstrated improvement in platelet counts and relative stabilization of renal parameters, including reduction in proteinuria and protein-creatinine ratio over time. Corticosteroids were tapered and eventually discontinued under specialist supervision without major documented exacerbation. Causal attribution assessment using the MONARCH inventory yielded a total score of +8, suggesting a temporal association between the individualized homeopathic intervention and the observed clinical course.

This case report describes a temporal association between adjunctive individualized homeopathic treatment and clinical stabilization in Class II mesangial lupus nephritis. The findings should be interpreted cautiously. This report does not support the replacement of standard-of-care therapy but suggests a possible supportive role that warrants further systematic investigation.