Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Department of Nephrology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Indian J Pathol Microbiol. 2020 Jul-Sep;63(3):397-404. doi: 10.4103/IJPM.IJPM_995_19.
Systemic lupus erythematosus is an autoimmune multisystem disease with a high predilection for renal involvement. Lupus nephritis develops in 20% to 75% within the first two years. Presentation varies from subnephrotic proteinuria to end-stage renal disease.
To study clinical features, biochemical, and serological parameters and correlate with histological activity and chronicity score [modified National Institute of Health (NIH) score].
Retrospective, cross-sectional, single-center based study in a tertiary care hospital of Eastern India.
We incuded 36 children with lupus nephritis diagnosed from February 2018 to March 2019. Laboratory data included were complete blood count (CBC), blood glucose, urine analysis, serum urea, creatinine, blood urea nitrogen (BUN), albumin, cholesterol, HBsAg, antihepatitis C virus (HCV) antibody, antistreptolysin O (ASO) titer, antinuclear antibody (ANA), myeloperoxidase antineutrophil cytoplasmic antibody (MPO ANCA), proteinase 3 antineutrophil cytoplasmic antibody (PR3 ANCA), double-stranded DNA (dsDNA), C3, and C4. Clinical parameters were age, sex, blood pressure (BP), skin lesions, arthralgia, edema, obesity. Renal biopsies examined with light microscopy, hematoxylin and eosin (H and E), periodic acid-Schiff (PAS), silver methanamine, Masson's trichrome (MT) stains. Immunofluorescence microscopy done with IgG, IgM, IgA, C3c, C1q, kappa, lambda antibodies.
Kruskal-Wallis and χ tests.
Mean age was 15.12 ± 3.49 and 12.5 ± 1.73 years for lupus nephritis (LN) with activity and LN without activity, respectively. Mean dsDNA was higher and mean C3 was lower (52.35 ± 22.21 mg/dl) in active LN. Mean 24-hour urinary protein was higher in LN without activity. Serum creatinine was raised in active LN. LN class III and IV showed higher activity than chronicity.
Pediatric LN is proliferative and more active as compared with adult counterparts. Activity scores are much higher than chronicity scores.
系统性红斑狼疮是一种自身免疫性多系统疾病，肾脏受累的倾向很高。狼疮肾炎在头两年内发展的比例为 20%至 75%。临床表现从亚肾病范围蛋白尿到终末期肾病不等。
研究临床特征、生化和血清学参数，并与组织学活动和慢性评分[改良的国立卫生研究院（NIH）评分]相关。
这是一项在印度东部一家三级保健医院进行的回顾性、横断面、单中心研究。
我们纳入了 2018 年 2 月至 2019 年 3 月期间诊断为狼疮肾炎的 36 名儿童。实验室数据包括全血细胞计数（CBC）、血糖、尿液分析、血清尿素、肌酐、血尿素氮（BUN）、白蛋白、胆固醇、HBsAg、抗丙型肝炎病毒（HCV）抗体、抗链球菌溶血素 O（ASO）滴度、抗中性粒细胞胞浆抗体（ANCA）、髓过氧化物酶抗中性粒细胞胞浆抗体（MPO-ANCA）、蛋白酶 3 抗中性粒细胞胞浆抗体（PR3-ANCA）、双链 DNA（dsDNA）、C3 和 C4。临床参数包括年龄、性别、血压（BP）、皮肤损伤、关节炎、水肿、肥胖。肾活检行光镜、苏木精和伊红（H 和 E）、过碘酸雪夫（PAS）、银甲胺、马松三色（MT）染色。免疫荧光显微镜检查 IgG、IgM、IgA、C3c、C1q、kappa、lambda 抗体。
Kruskal-Wallis 和 χ 检验。
狼疮肾炎活动组的平均年龄为 15.12±3.49 岁，狼疮肾炎无活动组的平均年龄为 12.5±1.73 岁。dsDNA 均值较高，C3 均值较低（52.35±22.21mg/dl），活动性狼疮肾炎组的均值较高。无活动性狼疮肾炎的 24 小时尿蛋白均值较高。血清肌酐在活动性狼疮肾炎中升高。狼疮肾炎 III 级和 IV 级的活动评分高于慢性评分。
与成人相比，儿科狼疮肾炎为增生性且更活跃。活动评分远高于慢性评分。
