Cetin Nuran, Acikalin Mustafa Fuat, Tufan Asli Kavaz, Kasifoglu Nilgun
Department of Pediatric Nephrology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
Department of Pathology, Eskişehir Osmangazi Üniversitesi Tıp Fakültesi, Eskisehir, Turkey.
Klin Padiatr. 2023 Sep;235(5):277-283. doi: 10.1055/a-1970-6301. Epub 2023 Mar 29.
We investigated the role of European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for the prediction of LN among children with SLE.
The data of the patients with childhood-onset SLE diagnosed based on 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were retrospectively evaluated. Based on 2019 EULAR/ACR classification criteria, the scoring was done at the time of renal biopsy.
Fifty-two patients (12 with LN, 40 without LN) were included. The mean score was higher in patients with LN than those without (30.8±6.14, 19.8±7.76, respectively, p=0.000). The score value had indicative value for LN (area under curve [AUC]:0.863±0.055, cut-off value:22.5, p=0.000). Lymphocyte counts had a predictive value for LN (cut-off value:905/mm3, AUC:0.688±0.087, p=0.042). The score was positively associated with SLE disease activity index (SLEDAI) and activity index (r=0.879, p=0.000; r=0.811, p=0.001, respectively). There were significant negative associations between score value and GFR (r=-0.582, p=0.047). The patients with renal flare had higher the mean score than those of without renal flare (35±2/25.4±5.57, respectively, p=0.019).
The EULAR/ACR criteria score could reflect the activity of disease and severity of nephritis in childhood-onset SLE. A point of 22.5 as score value might be an indicator for LN. During scoring, it should be taken into account that lymphopenia might guide the prediction of LN.
我们研究了欧洲抗风湿病联盟（EULAR）/美国风湿病学会（ACR）分类标准在预测儿童系统性红斑狼疮（SLE）狼疮性肾炎（LN）中的作用。
回顾性评估基于2012年系统性红斑狼疮国际协作临床（SLICC）标准诊断的儿童期起病SLE患者的数据。根据2019年EULAR/ACR分类标准，在肾活检时进行评分。
纳入52例患者（12例有LN，40例无LN）。有LN的患者平均评分高于无LN的患者（分别为30.8±6.14、19.8±7.76，p = 0.000）。评分值对LN有指示价值（曲线下面积[AUC]：0.863±0.055，临界值：22.5，p = 0.000）。淋巴细胞计数对LN有预测价值（临界值：905/mm³，AUC：0.688±0.087，p = 0.042）。评分与SLE疾病活动指数（SLEDAI）和活动指数呈正相关（r = 0.879，p = 0.000；r = 0.811，p = 0.001）。评分值与肾小球滤过率（GFR）之间存在显著负相关（r = -0.582，p = 0.047）。有肾脏病情复发的患者平均评分高于无肾脏病情复发的患者（分别为35±2/25.4±5.57，p = 0.019）。
EULAR/ACR标准评分可反映儿童期起病SLE的疾病活动度和肾炎严重程度。评分值22.5可能是LN的一个指标。在评分时，应考虑淋巴细胞减少可能有助于LN的预测。
