Clinical and pathological analysis of lupus nephritis in children

Objective To investigate the relationship between the pathological classification and clinical manifes-tation of lupus nephritis(LN) in pediatric patients by renal biopsy and laboratory examination.Methods The clinical and pathological data of 59 cases of LN in pediatric patients were retrospectively analyzed.Results Of the 59 cases,the most common clinical manifestation was nephrotic syndrome(NS),44.1%;followed by acute glomerulonephritis(AGN),23.7%;isolated hematuria or proteinuria,22.0%;and rare cases of rapidly progressive glomerulonephritis and chronic glomerulonephritis.The most common pathologic type was type Ⅳ-G(A),(40.7%) and Ⅳ-G(A/C)(15.3%),followed by type Ⅴ+ Ⅲ(8.5%),type Ⅴ + Ⅳ(6.8%),type Ⅱ(6.8%).LN patients with nephrotic syndrome were commonly found in pathologic type Ⅳ(65.4%) and type Ⅴ(26.9%).LN patients with pathologic type Ⅳ had the most serious tubular interstitial injury.There was a significantly positive correlation between serum creatinine level and severity of the tubular interstitial injury in renal biopsy(rs = 0.639,P 0.01).Patients with pathologic type Ⅳ had the highest positive rate of anti-dsDNA and the lowest level of serum complement.There are no differences in positive rates of antinu-clear antibody(ANA),anti-Sm,anti-RNP,anti-SSA,anti-SSB,and ESR between patients with different pathologic types.Conclusions There are some relationships between the clinical and pathological features of LN in pediatric patients.NS was the most common clinical manifestation which had a significant tendency to have the pathologic type Ⅳ and tubular interstitial injury.Promotion renal biopsy was important in diagnosis,treatment and prognosis of LN in pediatric patients.