Supplementary Material for: Efficacy of Belimumab for active lupus nephritis in a young Asian man with latent pulmonary tuberculosis: a case report

Introduction:
Managing active Lupus Nephritis (LN) in the presence of latent Tuberculosis (TB) presents a significant treatment challenge. Traditional treatment with glucocorticoids combined with mycophenolic acid carries a high risk of triggering pulmonary TB infection in LN patients. In this report, we discuss a novel approach using Belimumab in combination with rapidly tapering corticosteroids to treat a patient with active Class IV and V LN and latent TB.
Case presentation:
A 24-year-old Chinese male was diagnosed with active Class IV and V LN and latent TB. He underwent induction therapy with a combination of Belimumab, rapidly tapering methylprednisolone and Mycophenolate Mofetil. After 18 months of Belimumab therapy, the patient's blood albumin levels and kidney function normalized, with 24-hour urinary protein levels stabilizing between 500 mg and 725 mg. Notably, there was no recurrence of tuberculosis.
Conclusion:
This case demonstrates that the combination of Belimumab and rapid corticosteroid tapering effectively reduced the duration of high-dose glucocorticoid therapy, highlighting the efficacy and safety of Belimumab in managing lupus nephritis with latent TB.