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Abstract
Objective: Nephritis is a common manifestation of systemic lupus erythematosus. Understanding Lupus nephritis's clinical and paraclinical characteristics and treatment outcomes will help doctors predict the disease and choose appropriate treatment.
Methods: cross-sectional descriptive study with longitudinal follow-up of children with Lupus nephritis in the first 6 months of treatment.
Results: 31 children with Lupus nephritis had rates of edema, hypertension, gross hematuria, and decreased urine volume of 41.9%, 19.4%, 35.5%, and 6.5%, respectively. Rates of nephrotic-range proteinuria, serum albumin ≤ 30g/l, and glomerular filtration rate ≤ 90 ml/min/1.73m2 were 57.1%, 61.9%, and 34.6%, respectively. Grade 4 and grade 3 histopathological lesions accounted for the majority, with 50% and 35%. Hematological lesions, skin rash, hair loss, mouth ulcers, arthralgia, neuropsychiatric, cardiac, and digestive lesions accounted for 96.8%, 71.0%, 32.3%, 22.6%, 25.8%, 6.7%, 9.7%, and 6.7%, respectively. Most patients were treated with a Glucocorticoid + Mycophenolate regimen, and 74.2% had complete remission.
Conclusion: Clinical manifestations appeared with lower frequency than paraclinical features. Other common non-renal organ lesions were hematological and skin rash. The complete remission rate was satisfactory.
References
Perfumo F and Martini A. Lupus nephritis in children. Lupus. 2005; 14(1): 83-8.
Sinha R and Raut S. Pediatric lupus nephritis: Management update. World J Nephrol. 2014; 3(2): 16-23.
Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012; 64(8): 2677-86.
Tunnicliffe DJ, Singh-Grewal D, Kim S, Craig JC, and Tong A. Diagnosis, Monitoring, and Treatment of Systemic Lupus Erythematosus: A Systematic Review of Clinical Practice Guidelines. Arthritis Care Res (Hoboken). 2015; 67(10): 1440-52.
Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009; 20(3): 629-37.
Bajema IM, Wilhelmus S, Alpers CE, Bruijn JA, Colvin RB, Cook HT, et al. Revision of the International Society of Nephrology/Renal Pathology Society classification for lupus nephritis: clarification of definitions, and modified National Institutes of Health activity and chronicity indices. Kidney International. 2018; 93(4): 789-796.
Chapter 12: Lupus nephritis. Kidney Int Suppl (2011). 2012; 2(2): 221-232.
Nam NTT. Nghiên cứu lâm sàng, mô bệnh học và kết quả điều trị viêm thận lupus ở trẻ em. 2018, Trường Đại học Y Hà Nội.
Đếm Phan Văn Đếm, Nguyễn Thành Nam, and Kiên PT. Đặc điểm lâm sàng, cận lâm sàng và đáp ứng điều trị của viêm thận do Lupus ban đỏ ở trẻ em. VNU Journal of Science: Medical and Pharmaceutical Sciences. 2018; 34: 96.
Chan EY, Lai FF, Ma AL, and Chan TM. Managing Lupus Nephritis in Children and Adolescents. Paediatr Drugs. 2024; 26(2): 145-161.
Hari P, Bagga A, Mahajan P, and Dinda A. Outcome of lupus nephritis in Indian children. Lupus. 2009; 18(4): 348-354.
Biswas D, Dasgupta D, Pal P, and Sinha R. Presentation and outcome of pediatric lupus nephritis from a large single centre contemporary cohort in Eastern India. Lupus. 2023; 32(12): 1440-1446.
Thanh Đoàn Thị Mai Thanh, Phí Thị Như Trang, and Vinh NA. Một số đặc điểm dịch tễ học lâm sàng bệnh lupus ban đỏ hệ thống ở trẻ em tại Bệnh viện Nhi Trung ương. Tạp chí Y học Việt Nam. 2024; 533.
Park DJ, Joo YB, Bang SY, Lee J, Lee HS, and Bae SC. Predictive Factors for Renal Response in Lupus Nephritis: A Single-center Prospective Cohort Study. J Rheum Dis. 2022; 29(4): 223-231.
Miranda-Hernández D, Cruz-Reyes C, Angeles U, Jara LJ, and Saavedra MA. Prognostic Factors for Treatment Response in Patients With Lupus Nephritis. Reumatología Clínica (English Edition). 2014; 10(3): 164-169.
| Published | 28-12-2024 | |
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| Issue | Vol. 16 No. 9 (2024) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.16.9.7 | |
| Keywords | viêm thận, điều trị, Lupus, trẻ em |
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