A Clinico-Pathological Study Of Children With Lupus Nephritis

Objective: To analyze the clinical manifestation, test data and renal pathological changes inchildren with lupus nephritis (LN) in order to clear the relationship between clinicalphenotypes and pathological classification, treatment and prognosis.Method: The clinical manifestation, test data and renal pathological changes in96biopsy-proved lupus nephritis children hospitalized in Department of Pediatrics, Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology from January1991toDecember2010period were collected and analyzed.Result: Among96cases of children with lupus nephritis,22were males and74were females,the ratio of male to female was1:3.36. The age of onset was from3years10months to17years3months with an averrage age of11years2month. The illness duration beforediagnosis was4.7months.The initial complains in96patients were fever in90cases (93.8%),edema in87cases (90.6%), proteinuria in84cases(87.5%), hematuria in81cases (84.4%), skin andmucous membrane damage in60cases(62.5%), arthritis in34cases (35.4%),hypertension in81cases(20.8%), alopecia in11cases(11.5%) and nervous system symptoms in8cases(8.3%). TheClinical phenotypes were nephritic type nephrotic syndrome in58cases (60.4%), simple nephroticsyndrome in6cases(6.3%), acute nephritic syndrome in23cases(24.0%), hematuria and proteinuria in6cases(6.3%) and isolated proteinuria in3cases(3.1%). Acute renal insurfficiency was found in72.9%ofpatients, ANA increased in94cases(97.9%), C3decreased in93cases(96.8%), ESR increased in91cases(94.7%) and elevated immunoglobulin in88cases(91.7%). Pathological types of96cases weretype â…¡ in3cases (3.1%),III in14cases (14.6%), type IV in61cases(63.5%), type â…¤ in17cases(17.7%) and type â…¥ in only one cases(1.0%). All patients were treated with steroids andimmunosuppressive agents,2patients were died of severe complications., most patients got remission.Conclusion: LN are more common in girls, fever, edema and proteinuria are common first clinicalmanifestations. ANA, C3, ESR and urine tests are very helpful in the diagnosis of the disease, type â…£LN is the most common pathological type of the disease, nephritic nephrosis is the most commonclinical type. After individual treatment,most children can get good treatment.