Lupus Nephritis in Children: 21-Year Experience of a Single Center in Belarus
American Journal of Pediatrics
Volume 6, Issue 1, March 2020, Pages: 31-36
Received: Jan. 15, 2020; Accepted: Feb. 10, 2020; Published: Feb. 18, 2020
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Authors
Ina Kazyra, Department of Pediatrics, Belarus State Medical University, Minsk, Republic of Belarus
Alexander Sukalo, Department of Pediatrics, Belarus State Medical University, Minsk, Republic of Belarus
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Abstract
The article presents a historical and prospective analysis of the clinical and paraclinical data of a cohort of children suffering from systemic lupus erythematosus (SLE) with kidney damage, observed in a single center for 21 year. The case histories of 62 patients (51 girls and 11 boys) with a diagnosis of SLE and lupus nephritis (LN) who were monitored and treated at the Byelorussian Center for Pediatric Nephrology and Renal Replacement Therapy of the 2nd Children's Clinical Hospital in Minsk in the period from 1998 to 2019 yrs. We evaluated the initial manifestations of the disease, age of the onset, time of diagnosis (from the first symptom to the diagnosis), clinical manifestations at the time of diagnosis, the duration of SLE and treatment at the time of kidneys biopsy, as well as the activity of the disease. During the observation period (from 3 months up to 12 years) the frequency of extrarenal and renal exacerbations was analyzed, and the activity, treatment and outcome were evaluated. Male gender and early debut are factors worsening the prognosis of the disease (55% of boys showed progression of CRF). In children, the disease proceeds with a high degree of activity, rapid multi-organ involvement, requires more aggressive therapy with prescription of several immunosuppressive agents, which increases the risk of infection. Nephritis is an unfavorable prognostic criterion and is crucial in determining the volume of therapy for SLE. Noncompliance in therapy, social status were factors of an unfavorable outcome in children. Timely diagnosis and aggressive intervention to suppress the activity of the disease should be used to prevent chronic irreversible damage. Children with SLE and kidney damage are at high risk for early development of cardiovascular disorders. Steroid-sparing strategies must be actively implemented in clinical practice in order to prevent severe side effects.
Keywords
Systemic Lupus Erythematosus, Lupus Nephritis, Children
To cite this article
Ina Kazyra, Alexander Sukalo, Lupus Nephritis in Children: 21-Year Experience of a Single Center in Belarus, American Journal of Pediatrics. Special Issue: Chronic Kidney Disease in Children. Vol. 6, No. 1, 2020, pp. 31-36. doi: 10.11648/j.ajp.20200601.15
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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