Successful Cyclosporine Salvage Therapy in Refractory Lupus Nephritis: A Case Study from Ethiopia

Lupus nephritis is a serious manifestation of systemic lupus erythematosus, commonly managed with corticosteroids, mycophenolate mofetil (MMF), or cyclophosphamide. Calcineurin inhibitors (CNIs) have demonstrated therapeutic potential, but their availability in low-income settings remains limited. We report a 28-year-old Ethiopian woman with class V lupus nephritis and nephrotic syndrome who presented with fatigue and generalized edema. Despite initial therapy with MMF and corticosteroids, her condition failed to improve. Introduction of cyclosporine-based triple therapy, combined with supportive care, resulted in partial remission and clinical stabilization. This case underscores the potential role of cyclosporine as a salvage therapy in class V lupus nephritis when standard regimens are ineffective or inaccessible. In resource-limited settings, cyclosporine may represent a pragmatic therapeutic option. Further controlled studies are warranted to evaluate its efficacy and to define its place in treatment algorithms.