儿童狼疮性肾炎分型及治疗策略

doi:10.12372/jcp.2023.23e0916

Abstract

Abstract:

Lupus nephritis (LN) is the most common glomerular disease in children, with a more severe onset and progression compared to adults. The prognosis of LN in children is worse than other glomerular diseases and has lifelong effects, although the etiology remains unclear. This article provides an overview of the current diagnosis and treatment status of LN in children, along with a brief description of the treatment for each type of LN based on the latest international guidelines. LN was diagnosed according to the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus. Renal biopsy pathology is an important diagnostic method at present. Treatment for proliferative and non-proliferative LN includes initial therapy and maintenance therapy, following recommendations from adult guidelines. Rational and proactive treatment is crucial for inducing disease remission, preventing relapse, and improving prognosis.

Key words: systemic lupus erythematosus, lupus nephritis, treatment, child

GAO Chunlin. Renal pathologic classification and treatment strategy in children with lupus nephritis[J].Journal of Clinical Pediatrics, 2023, 41(12): 887-894.

Figures/Tables 1

References 42

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治疗	方案	LN Ⅰ、Ⅱ型	LN Ⅲ、Ⅳ（±Ⅴ）型	LN Ⅴ型
初始治疗	常用方案	①非肾病范围蛋白尿：肾外表现来决定免疫抑制剂 ②肾病范围蛋白尿：GC ③镜下血尿：不需要针对肾病治疗 ④足细胞病：GC	①GC+MPAA ②GC+CTX ③GC+贝利尤单抗+MPAA或低剂量CTX ④GC+MPAA+CNIs	①非肾病范围蛋白尿：肾外表现来决定免疫抑制剂 ②肾病范围蛋白尿：GC+MPAA或GC+CTX（<6个月）或GC+CNIs或GC+利妥昔单抗（RTX）或GC+AZA
初始治疗	替代方案		GC+AZA GC+来氟米特
维持治疗		MPAA/AZA/贝利尤单抗
基础治疗	羟氯喹

Renal pathologic classification and treatment strategy in children with lupus nephritis

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