Clinical and Pathological Analysis of 91 Children with Lupus Nephritis

Objective To analyze the clinical and pathological characteristics of children with lupus nephritis(LN).Methods Ninety-one children with LN were diagnosed from 1993 to 2005,according to the clinical literature and renal pathology and the data were retrospectively summarized.Results Within the cohort of 91 children,there were 69 females and 22 males(female to male ratio 3.1).Most of the sick children were at the school age ranging from 6.0 to 15.5 years old.Nephrotic syndrome(44.0%) was the most common clinical manifestation.Fifty-nine renal biopsies were performed.Class Ⅳ LN(59.3%) was the most frequent pathological findings.A full-house pattern on immunofluorescence was found in 72.0% of biopsies.The clinical and pathological manifestations of some children were atypical.There were 3 patients characterized by predominant deposits of immunoglobulin M(IgM),1 patient with predominant deposits of IgA,and 2 children with pauci-immune LN.Three children with class Ⅱ LN in our study presented with nephrotic syndrome.LN was initially controlled by aggressive treatment in 93.7% of thse patients.Relapses of nephritis covered 27.1% of them,mostly caused by the intermittent treatment.Conclusions The clinical and pathological manifestations of LN were variable.Some atypical LN was considered to be associated with the distinct pathogenesis.Most of LN could be controlled by aggressive treatment.Long and regular treatment is necessary to improve the prognosis of LN.