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儿童狼疮性膜性肾病的预后

Prognosis of lupus membranous nephropathy in children.

作者信息

Nathanson Sylvie, Salomon Rémi, Ranchin Bruno, Macher Marie-Alice, Lavocat Marie-Pierre, Krier Marie-Jeanne, Baudouin Véronique, Azéma Christine, Bader-Meunier Brigitte, Deschênes Georges

机构信息

Pediatric Unit, Hôpital Mignot, 177 rue de Versailles, 78150, le Chesnay, France.

出版信息

Pediatr Nephrol. 2006 Aug;21(8):1113-6. doi: 10.1007/s00467-006-0129-z. Epub 2006 Jun 30.

Abstract

The occurrence of membranous nephropathy in pediatric series of systemic lupus erythematosus has been reported only rarely, probably due to a very low frequency. One hundred fifty-four children who were seen in 100 French pediatric centers between January 2002 and April 2005 were included. Fifteen (12 girls and three boys) out of the 81 (18.5 %) children with renal involvement presented histological features of membranous nephropathy. Their ages ranged from six to 15 years old (mean=11.3) at the age of SLE diagnosis and 8/15 children were of African origin. Isolated membranous nephropathy was observed in nine patients, of whom five patients displayed a complete recovery following immunosuppressive treatment. Associated proliferative lesions were observed on the first kidney specimen in two patients and in a further renal biopsy in four other patients, leading to a less favorable course of lupus nephropathy.

摘要

小儿系统性红斑狼疮并发膜性肾病的报道极为罕见,可能是因为其发病率极低。纳入了2002年1月至2005年4月间在100家法国儿科中心就诊的154名儿童。在81名(18.5%)有肾脏受累的儿童中,有15名(12名女孩和3名男孩)呈现出膜性肾病的组织学特征。他们在系统性红斑狼疮诊断时的年龄为6至15岁(平均=11.3岁),其中8/15的儿童为非洲裔。9例患者出现孤立性膜性肾病,其中5例患者在接受免疫抑制治疗后完全康复。2例患者在首次肾脏标本中观察到相关增殖性病变,另有4例患者在进一步的肾脏活检中观察到相关增殖性病变,导致狼疮性肾病的病程预后较差。

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