Management of Lupus Nephritis in Children

Scobell, Rebecca; Pradhan, Madhura

doi:10.1007/s13312-020-1811-0

Cited by 6 publications

(6 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our cohort, approximately 34% of children needed a renal biopsy to stage the disease, and class IV LN was the commonest lesion (n=14, 36.8%). It was similar to a study by Mackie et al in which 33% underwent renal biopsy and 8 out of 11 patients (72%) had class IV LN [14,15]. In the present study, the interquartile range of the activity index for classes III and IV was higher than the chronicity score.…”

Section: Discussionsupporting

confidence: 92%

“…Similar to other studies, adolescents and female children were predominantly affected, and a strong female preponderance (n=30; 78.9%) was noted overall, with the male to female ratio of 2:7.5 [13][14][15]. Male lupus was high in this study compared to other studies from India [3,15]. Among the renal manifestations, proteinuria was the most common (n=38, 100%), followed by anasarca (n=12; 31.5%), hypertension (n=10; 26.3%) and others.…”

Section: Discussionsupporting

confidence: 87%

“…Rakesh et al conducted a study in eastern India which showed 3.9% of children who presented to the rheumatology outpatient clinic had SLE [ 6 ]. Similar to other studies, adolescents and female children were predominantly affected, and a strong female preponderance (n=30; 78.9%) was noted overall, with the male to female ratio of 2:7.5 [ 13 - 15 ]. Male lupus was high in this study compared to other studies from India [ 3 , 15 ].…”

Section: Discussionsupporting

confidence: 86%

See 2 more Smart Citations

Analysis of Clinicopathological Characteristics and Its Correlation With the Prognosis of Pediatric Lupus Nephritis: A Tertiary Care Center Experience

Barathi¹,

Janarthanan²,

S³

et al. 2022

Cureus

View full text Add to dashboard Cite

To study the various pathological patterns of pediatric lupus nephritis (LN) by renal biopsies and to correlate the histopathological data with the clinical and biochemical outcomes. MethodsThis is a retrospective study in children between 1 month and 18 years of age with renal biopsy-proven lupus nephritis, conducted between January 2015 and December 2019. Various pathological and clinical parameters were compared between the groups with lupus nephritis activity and those without activity. ResultsOf 38 biopsy-proven lupus nephritis cases, 30 (78.9%) were in the adolescent age group, and the female gender was predominantly affected (n=30; 78.9%). Class IV proliferative lupus nephritis (n=17, 44.7%) was the most common biopsy finding, and the activity score for endocapillary hypercellularity, neutrophil infiltration, fibrinoid necrosis, hyaline deposits, and interstitial inflammation was significantly high in classes III and IV. Overall, attaining remission was less, and the risk of progression of chronic kidney disease (CKD) was higher in class IV (n=3; 7.8%). Mortality was reported in 1 out of 38 (2.6%) children. ConclusionLight microscopy and immunofluorescence studies play an important role in defining the extent of renal damage in the form of activity and chronicity indices, which are the key factors in the decision-making of lupus nephritis treatment. The prognostic relevance of the histological scoring has been evaluated, and it is evident that the activity index and chronicity index go a long way in therapeutic intervention.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

See 1 more Smart Citation

Analysis of Clinicopathological Characteristics and Its Correlation With the Prognosis of Pediatric Lupus Nephritis: A Tertiary Care Center Experience

Barathi¹,

Janarthanan²,

S³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…cSLE comprises approximately 15-20% of SLE cases, with a prevalence of 1.89-25.7 per 100,000 children and an annual incidence of less than 1 per 100,000 children, rendering it a rare disease in childhood, with considerably lower rates than adults. Accordingly, clinical research is more challenging, and evidence-based guidelines are lacking (5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

“…Compared to aSLE, cSLE exhibits higher frequencies of kidney, neuropsychiatric, and hematologic involvement (1,4). Lupus nephritis (LN) continues to be a prominent source of morbidity and mortality in SLE, reported in 30-40% of cSLE patients (3)(4)(5)(8)(9)(10)(11). LN is more frequent in Hispanics, and African descendants, showing higher levels of disease activity and risk of developing kidney failure compared to non-Hispanic whites (6).…”

Section: Introductionmentioning

confidence: 99%

Urine ALCAM, PF4 and VCAM-1 Surpass Conventional Metrics in Identifying Nephritis Disease Activity in Childhood-Onset Systemic Lupus Erythematosus

et al. 2022

View full text Add to dashboard Cite

ObjectivesSerial kidney biopsy for repeat evaluation and monitoring of lupus nephritis (LN) in childhood-onset Systemic Lupus Erythematosus (cSLE) remains challenging, thus non-invasive biomarkers are needed. Here, we evaluate the performance of ten urine protein markers of diverse nature including cytokines, chemokines, and adhesion molecules in distinguishing disease activity in cSLE.MethodsEighty-four pediatric patients meeting ≥4 ACR criteria for SLE were prospectively enrolled for urine assay of 10 protein markers normalized to urine creatinine, namely ALCAM, cystatin-C, hemopexin, KIM-1, MCP-1, NGAL, PF-4, Timp-1, TWEAK, and VCAM-1 by ELISA. Samples from active renal (LN) and active non-renal SLE patients were obtained prior to onset/escalation of immunosuppression. SLE disease activity was evaluated using SLEDAI-2000. 59 patients had clinically-active SLE (SLEDAI score ≥4 or having a flare), of whom 29 patients (34.5%) were classified as active renal, and 30 patients (35.7%) were active non-renal. Twenty-five healthy subjects were recruited as controls.ResultsUrine concentrations of ALCAM, KIM-1, PF4 and VCAM-1 were significantly increased in active LN patients versus active non-renal SLE, inactive SLE and healthy controls. Five urine proteins differed significantly between 2 (hemopexin, NGAL, MCP1) or 3 (Cystatin-C, TWEAK) groups only, with the highest levels detected in active LN patients. Urine ALCAM, VCAM-1, PF4 and hemopexin correlated best with total SLEDAI as well as renal-SLEDAI scores (p < 0.05). Urine ALCAM, VCAM-1 and hemopexin outperformed conventional laboratory measures (anti-dsDNA, complement C3 and C4) in identifying concurrent SLE disease activity among patients (AUCs 0.75, 0.81, 0.81 respectively), while urine ALCAM, VCAM-1 and PF4 were the best discriminators of renal disease activity in cSLE (AUCs 0.83, 0.88, 0.78 respectively), surpassing conventional biomarkers, including proteinuria. Unsupervised Bayesian network analysis based on conditional probabilities re-affirmed urine ALCAM as being most predictive of active LN in cSLE patients.ConclusionUrinary ALCAM, PF4, and VCAM-1 are potential biomarkers for predicting kidney disease activity in cSLE and hold potential as surrogate markers of nephritis flares in these patients.

show abstract

Profile of juvenile systemic lupus erythematosus patients with a special reference to monogenic lupus and lupus nephritis: a cross-sectional study

Bhattad,

Singh,

Janardhanan

et al. 2024

Rheumatol Int

View full text Add to dashboard Cite

Management of Lupus Nephritis in Children

Cited by 6 publications

References 30 publications

Analysis of Clinicopathological Characteristics and Its Correlation With the Prognosis of Pediatric Lupus Nephritis: A Tertiary Care Center Experience

Analysis of Clinicopathological Characteristics and Its Correlation With the Prognosis of Pediatric Lupus Nephritis: A Tertiary Care Center Experience

Urine ALCAM, PF4 and VCAM-1 Surpass Conventional Metrics in Identifying Nephritis Disease Activity in Childhood-Onset Systemic Lupus Erythematosus

Profile of juvenile systemic lupus erythematosus patients with a special reference to monogenic lupus and lupus nephritis: a cross-sectional study

Contact Info

Product

Resources

About