Case of class II lupus nephritis with nephrotic features in the context of belimumab: Intersecting clinical challenge with academic initiative to emphasize social barriers in care.

Lupus nephritis is a severe complication of systemic lupus erythematosus that can cause significant kidney damage, leading to symptoms such as proteinuria, hematuria, and renal failure. If not managed promptly, it can progress to chronic kidney disease or even end-stage renal disease. Early diagnosis and treatment are vital to prevent such outcomes. While traditional treatments focus on immunosuppressive therapies, the introduction of belimumab offers a new treatment approach. Kidney biopsies play a crucial role in diagnosing and classifying lupus nephritis, helping guide appropriate treatment. Class II lupus nephritis typically requires supportive care, but more severe cases demand aggressive therapy. Noncompliance with treatment can worsen the condition, highlighting the need to address social challenges that impact patient care and adherence. We hereby report a 19-year-old female with systemic lupus erythematosus and nephrotic-range proteinuria, diagnosed with Class II lupus nephritis shortly after initiating belimumab, highlighting the social challenges impacting her care and follow-up. We hereby report a 19-year-old female known with systemic lupus erythematosus with nephrotic-range proteinuria and Class II lupus nephritis. Diagnosed shortly after belimumab, and highlighting the social challenges in her care and follow-up.