Crescentic Glomerulonephritis in a 65-year-old Male Patient with Lepromatous Leprosy: Case Report

Leprosy, a chronic infectious disease caused by Mycobacterium leprae, can involve multiple organ systems; however, renal manifestations are uncommon and often under-recognized, especially in the geriatric population. We report a rare case of a 65-year-old male with untreated multibacillary leprosy who presented with acute kidney injury and respiratory distress. Further evaluation uncovered an uncommon glomerular pathology (necrotising crescentic glomerulonephritis) necessitating both immunosuppressive therapy and multi-drug treatment for leprosy. This case highlights the diagnostic and therapeutic challenges in the geriatric population, where age-related changes, comorbidities, and atypical presentations can delay diagnosis. It underscores the importance of maintaining a high index of suspicion for leprosy and its systemic complications—including glomerulonephritis—especially in older patients, where it is often overlooked. Early diagnosis through renal biopsy facilitated appropriate management in this patient. The case emphasizes the importance of integrated, multidisciplinary, and accessible healthcare approaches for older adults with leprosy, particularly those presenting with multi-organ involvement.