2019
DOI: 10.1590/2175-8239-jbn-2018-0097
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Pediatric lupus nephritis

Abstract: Involvement of the kidneys by lupus nephritis (LN) is one of the most severe clinical manifestations seen in individuals with systemic lupus erythematosus (SLE). LN is more frequent and severe in pediatric patients and has been associated with higher morbidity and mortality rates. This narrative review aimed to describe the general aspects of LN and its particularities when affecting children and adolescents, while focusing on the disease's etiopathogenesis, clinical manifestations, renal tissue alterations, a… Show more

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Cited by 46 publications
(44 citation statements)
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References 69 publications
(306 reference statements)
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“…Moreover, anti-C1q autoantibodies and corresponding immune complexes relate to renal involvement, highlighting the protective function of the classical pathway in clearing immune complexes. However, once the disease is triggered and immune complexes are insufficiently cleared, their deposition in tissue leads to local complement activation, mainly driven by terminal complement components, indicated by decreased systemic levels of C3 and C4, suggesting high inflammatory activity and tissue damage (69)(70)(71)(72)(73). Furthermore, complement has been shown to contribute to the disease by increased C3aR and C5aR activity (74,75), and elevated C5a levels (76).…”
Section: Lupus Nephritismentioning
confidence: 99%
“…Moreover, anti-C1q autoantibodies and corresponding immune complexes relate to renal involvement, highlighting the protective function of the classical pathway in clearing immune complexes. However, once the disease is triggered and immune complexes are insufficiently cleared, their deposition in tissue leads to local complement activation, mainly driven by terminal complement components, indicated by decreased systemic levels of C3 and C4, suggesting high inflammatory activity and tissue damage (69)(70)(71)(72)(73). Furthermore, complement has been shown to contribute to the disease by increased C3aR and C5aR activity (74,75), and elevated C5a levels (76).…”
Section: Lupus Nephritismentioning
confidence: 99%
“…Participants in this study should meet the inclusion and exclusion criteria. The inclusion criteria included patients diagnosed with LN, 11,12 aged 6-18 years, were in the induction or maintenance phase. The induction phase consisted of a new patient diagnosed with LN for up to 6 months.…”
Section: Patients and Methods Participantsmentioning
confidence: 99%
“…If using a combination with CPA, post-CPA induction pulse was given every 3 months for 24 months (a total treatment period of 30 months) and then stopped. 12 Participant exclusion criteria included children experiencing mental retardation, cerebral palsy, participant fever/temperature >37.5°C, high leukocyte levels, and parents unwilling to take part in research. Participants have received an explanation of the participant's goals, benefits, rights and obligations during the study.…”
Section: Patients and Methods Participantsmentioning
confidence: 99%
“…The RAAS is also involved in the physiopathology of autoimmune diseases, including rheumatoid arthritis and lupus nephritis (LN). LN is the result of acute kidney inflammation triggered by the deposition of autoantibodies and immune complexes in the kidney [ 124 ]. Accordingly, several studies have shown that Ang II has pro-inflammatory effects in autoimmune diseases due to regulation of chemokines, cytokines, and chemotactic agents, including TGF-β1, TNF, IL-6, osteopontin, and NF-kappa B [ 125 ].…”
Section: Role Of Classical and Alternative Raas Axes In Pediatric Kidmentioning
confidence: 99%
“…Similar to glomerular diseases, LN can have a wide spectrum of presentations, from minimal mesangial injury to advanced glomerular sclerosis. Likewise, both diseases might be attenuated by the use of ACEI and ARBs, in order to provide renoprotection and reduction of proteinuria [ 124 ]. Albuquerque et al [ 126 ] showed that captopril was able to reduce TGF-β1 expression in the glomeruli and TGF-β2 expression in the periglomerular region of mice with lupus.…”
Section: Role Of Classical and Alternative Raas Axes In Pediatric Kidmentioning
confidence: 99%