Clinicopathological, Immunological, and Laboratory Parameters of Childhood Lupus Nephritis: A Study from Northeast India

Abstract

Background Lupus nephrtis in children is associated with high morbidity and mortality. The incidence of childhood systemic lupus erythematosus (SLE) ranges from 3.3 to 8.8/100000 children with a higher Asian preponderance. The predominance of SLE in female pediatric patients increases gradually with age to the values observed in adults. Objectives To assess the clinical, immunological, and histopathological spectrum of childhood lupus nephritis in northeast India and explore the relationship between clinical, biochemical, serological, and histopathological findings. Materials and Methods A retrospective descriptive study was performed over 8 years. Histopathology slides were reviewed by two pathologists, whereas other details were collected from patients' records. Statistical Analysis Statistical analysis was based on the chi-square test and a p-value < 0.05 was considered statistically significant. Results Fifty-three cases of lupus nephritis were included in the study. The patients' age ranged from 5 to 18 years with a mean age of 14.5 years and a female: male ratio of 6.5:1. Edema and hypertension were the commonest clinical presentations, whereas proteinuria was the commonest presenting laboratory parameter. Amongst all the immunological markers, dsDNA was the commonest. Histopathologically, predominantly study population belonged to class IV lupus nephritis. The patients with class IV showed a statistically significant correlation with proteinuria and hematuria at the time of diagnosis. Immunological markers, namely, ANA and anti-ds-DNA positivity were significantly associated with advanced renal histopathology. Conclusion cSLE in northeast India presents mostly as Class IV LN presenting mostly with deranged laboratory parameters and preponderance of various immunological markers and clinical presentations.

Lupus Nephritis in Northeastern India: Navigating the complex landscape of clinical challenges and emerging healthcare opportunities

“…The prevalence of lupus nephritis (LN) is higher in Indo-Asians in comparison to the white population 6 . In a study done by Das J et al 7 in the north eastern India, the prevalence of paediatric and adolescent lupus nephritis was found to be 11.3%, which was slightly higher than the prevalence seen in other studies. The prevalence of Lupus Nephritis among SLE patients in North Eastern India appears to be higher than the national average.…”

Natural Killer Cell Count in Systemic Lupus Erythematosus Patients: A Flow Cytometry-Based Study

“…Out of these, the majority of the cases (25%) were diagnosed with class IV lupus nephritis as per the International Society of Nephrology/Renal Pathology Society classification. In a study done by Das et al, 2023, the majority of the lupus nephritis cases were Class IV [11].…”