Journal of Clinical Pediatrics >
Clinical characteristics and diagnosis of lupus nephritis in children
Received date: 2023-10-10
Online published: 2023-12-04
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by immune dysregulation and autoantibody formation. With the progress of treatment, the survival rate of SLE patients has improved significantly. Even so, lupus nephritis (LN) is associated with high morbidity and mortality. At present, there is a lack of data on LN in children, and its diagnosis, treatment and monitoring are mainly based on guidelines for adults. Treatment is mainly based on hormones and immunosuppressants. Recently, biologics have been used to treat LN with good results and no obvious adverse reactions. This article reviews the progress of epidemiology, clinical features, pathogenesis, diagnosis and treatment of LN in children.
Key words： lupus nephritis; diagnosis; treatment; child
Zhengkun XIA , Ren WANG . Clinical characteristics and diagnosis of lupus nephritis in children[J]. Journal of Clinical Pediatrics, 2023 , 41(12) : 881 -886 . DOI: 10.12372/jcp.2023.23e0979
| [1] | Chan EY, Yap DY, Wong WT, et al. Long-term outcomes of children and adolescents with biopsy-proven childhood-onset lupus nephritis[J]. Kidney Int Rep, 2022, 8(1): 141-150. |
| [2] | Diaz-Frias J, Badri T. Neonatal lupus erythematosus[M]. Treasure Island (FL): StatPearls Publishing, 2023. |
| [3] | Parikh SV, Almaani S, Brodsky S, et al. Update on lupus nephritis: core curriculum 2020[J]. Am J Kidney Dis, 2020, 76(2): 265-281. |
| [4] | Qiu S, Zhang H, Yu S, et al. Clinical manifestations, prognosis, and treat-to-target assessment of pediatric lupus nephritis[J]. Pediatr Nephrol, 2022, 37(2): 367-376. |
| [5] | Shi Y, Bi D, Wang Y, et al. Chinese SLE Treatment and Research Group Registry (CSTAR) XIV: the subjective well-being of patients with systemic lupus erythematosus[J]. Front Med (Lausanne), 2022, 9: 984183. |
| [6] | Gutiérrez-Suárez R, Ruperto N, Gastaldi R, et al. A proposal for a pediatric version of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index based on the analysis of 1, 015 patients with juvenile-onset systemic lupus erythematosus[J]. Arthritis Rheum, 2006, 54(9): 2989-2996. |
| [7] | Pinheiro SVB, Dias RF, Fabiano RCG, et al. Pediatric lupus nephritis[J]. J Bras Nefrol, 2019, 41(2): 252-265. |
| [8] | Weiss JE, Sison CP, Ilowite NT, et al. Flares in pediatric systemic lupus erythematosus[J]. J Rheumatol, 2007, 34(6): 1341-1344. |
| [9] | Aggarwal A, Phatak S, Srivastava P, et al. Outcomes in juvenile onset lupus: single center cohort from a developing country[J]. Lupus, 2018, 27(11): 1867-1875. |
| [10] | Yung S, Yap DY, Chan TM. A review of advances in the understanding of lupus nephritis pathogenesis as a basis for emerging therapies[J]. F1000 Res, 2020, 9: F1000 Faculty Rev-905. |
| [11] | Hagberg N, R?nnblom L. Interferon-α enhances the IL-12-induced STAT4 activation selectively in carriers of the STAT4 SLE risk allele rs7574865 [T][J]. Ann Rheum Dis, 2019, 78(3): 429-431. |
| [12] | Azzouz D, Omarbekova A, Heguy A, et al. Lupus nephritis is linked to disease-activity associated expansions and immunity to a gut commensal[J]. Ann Rheum Dis, 2019, 78(7): 947-956. |
| [13] | Peene I, Elewaut D. Changing the wolf from outside: how microbiota trigger systemic lupus erythematosus[J]. Ann Rheum Dis, 2019, 78(7): 867-869. |
| [14] | Kostopoulou M, Fanouriakis A, Bertsias G, et al. Annals of the rheumatic diseases collection on lupus nephritis (2019-2022): novel insights and advances in therapy[J]. Ann Rheum Dis, 2023, 82(6): 729-733. |
| [15] | Frangou E, Chrysanthopoulou A, Mitsios A, et al. REDD1/autophagy pathway promotes thromboinflammation and fibrosis in human systemic lupus erythematosus (SLE) through NETs decorated with tissue factor (TF) and interleukin-17A (IL-17A)[J]. Ann Rheum Dis, 2019, 78(2): 238-248. |
| [16] | Reid S, Alexsson A, Frodlund M, et al. High genetic risk score is associated with early disease onset, damage accrual and decreased survival in systemic lupus erythematosus[J]. Ann Rheum Dis, 2020, 79(3): 363-369. |
| [17] | 中华医学会儿科学分会免疫学组, 中华儿科杂志编辑委员会. 中国儿童系统性红斑狼疮诊断与治疗指南[J]. 中华儿科杂志, 2021, 59(12): 1009-1024. |
| [18] | Fanouriakis A, Kostopoulou M, Cheema K, et al. 2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis[J]. Ann Rheum Dis, 2020, 79(6): 713-723. |
| [19] | 中华医学会儿科学分会肾脏学组. 狼疮性肾炎诊治循证指南(2016)[J]. 中华儿科杂志, 2018, 56(2): 88-94. |
| [20] | Weening JJ, D'Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited[J]. Kidney Int, 2004, 65(2): 521-530. |
| [21] | Kaneko M, Jackson SW. Recent advances in immuno-therapies for lupus nephritis[J]. Pediatr Nephrol, 2023, 38(4): 1001-1012. |
| [22] | ?tambuk SK, Padjen I, Juki? NB, et al. Rescue treatment of severe lupus myocarditis and proliferative lupus nephritis with immunoadsorption[J]. Clin Rheumatol, 2023, 42(6): 1723-1725. |
| [23] | Thakur N, Rai N, Batra P. Pediatric lupus nephritis-review of literature[J]. Curr Rheumatol Rev, 2017, 13(1): 29-36. |
| [24] | Liu Z, Zhang H, Liu Z, et al. Multitarget therapy for induction treatment of lupus nephritis: a randomized trial[J]. Ann Intern Med, 2015, 162(1): 18-26. |
| [25] | Rovin BH, Solomons N, Pendergraft WF 3rd, et al. A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis[J]. Kidney Int, 2019, 95(1): 219-231. |
| [26] | Palmer SC, Tunnicliffe DJ, Singh-Grewal D, et al. Induction and maintenance immunosuppression treatment of proliferative lupus nephritis: a network meta-analysis of randomized trials[J]. Am J Kidney Dis, 2017, 70(3): 324-336. |
| [27] | van Gelder T, Lerma E, Engelke K, et al. Voclosporin: a novel calcineurin inhibitor for the treatment of lupus nephritis[J]. Expert Rev Clin Pharmacol, 2022, 15(5): 515-529. |
| [28] | 中华医学会肾脏病学分会专家组. 利妥昔单抗在肾小球肾炎中应用的专家共识[J]. 中华肾脏病杂志, 2022, 38(2): 151-160. |
| [29] | Yu C, Li P, Dang X, et al. Lupus nephritis: new progress in diagnosis and treatment[J]. J Autoimmun, 2022, 132: 102871. |
| [30] | Plü? M, Piantoni S, Tampe B, et al. Belimumab for systemic lupus erythematosus - Focus on lupus nephritis[J]. Hum Vaccin Immunother, 2022, 18(5): 2072143. |
| [31] | Furie R, Nicholls K, Cheng TT, et al. Efficacy and safety of abatacept in lupus nephritis: a twelve-month, randomized, double-blind study[J]. Arthritis Rheumatol, 2014, 66(2): 379-389. |
| [32] | ACCESS Trial Group. Treatment of lupus nephritis with abatacept: the Abatacept and Cyclophosphamide Combination Efficacy and Safety Study[J]. Arthritis Rheumatol, 2014, 66(11): 3096-3104. |
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