Clinical presentation varies in children with lupus nephritis

Children diagnosed with proliferative forms of lupus nephritis (LN) have varying clinical presentations, according to a study.

In this retrospective analysis, the medical records of 39 children hospitalized due to LN were analyzed for Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), histological LN findings with the activity (IA), and chronicity index (IC).

The mean age at LN onset was 14.75 years, with a mean of SLEDAI of 22.0 points, IA 8.0 (IQR 6.0-11.0) points, and IC 1.05 (IQR 0-2.0) points. In total, 59.4% of patients had LN histological class IV, 18.9% had class III, 10.8% had class III/V, 8.1% had class IV/V, and 2.7% had class VI.

Children with nephrotic (n ​= ​22) and non-nephrotic (n ​= ​17) proteinuria had different median Hb levels (9.55 vs 10.9 ), albumin levels (2.5 vs 3.6; P ​< ​0.001), proteinuria (5.76, vs 1.08; P ​< ​0.0001), eGFR (53.9 vs 96.7; P ​< ​0.01), and occurrence of hypertension (77% vs 23%; P ​< ​0.01). In multivariate analysis, Hb level was the significant predictor of eGFR<90 ​mL/min/1.73 ​m2.

Reference
Szymanik-Grzelak H, Barabasz M, Wikiera-Magott I, et al. Retrospective analysis of clinical and pathomorphological features of lupus nephritis in children. Adv Med Sci. 2021 Feb 2;66(1):128-137. doi: 10.1016/j.advms.2021.01.004. Epub ahead of print. PMID: 33545446.