Ghio L, Edefonti A, Cohen E, Giani M, Miglioli E, Bardare M
Pediatr Med Chir. 1986 May-Jun;8(3):325-8.
The outcome of lupus nephritis was studied in 12 children. Their age at onset was 5-13 years (mean 9.8 +/- 2.1 years), less than that reported in recent years of children with lupus nephritis. All patients had clinical symptoms and signs and/or laboratory findings of renal involvement. Renal biopsy, performed in all patients, showed: minimal change in 3 patients, mesangial glomerulonephritis in 5, focal proliferative glomerulonephritis in 3 and membranous glomerulonephritis in one patient. There was no correlation between age at onset and histological categories, while clinical data were well correlated with the degree of histological involvement. 11 patients were followed for 5.16 +/- 3.2 years (range 1-13 years); 7 patients are in complete remission, 3 patients have only microscopic hematuria and/or mild proteinuria, one patient died because of infection complicating pulmonary involvement. Our report confirms a more favorable evolution of lupus nephritis in children than in adults. In particular none of our patients whose disease started before the age of 10 years had poor outcome, in contrast to previous report describing a higher mortality and morbidity in younger children. The more favorable prognosis of our patients could depend not only on the absence of the more severe form of lupus nephritis that is diffuse proliferative glomerulonephritis, but also on the earlier diagnosis and subsequent therapy.
对12名儿童狼疮性肾炎的预后进行了研究。他们发病时的年龄为5至13岁（平均9.8±2.1岁），低于近年来报道的儿童狼疮性肾炎患者的年龄。所有患者均有肾脏受累的临床症状、体征和/或实验室检查结果。所有患者均进行了肾活检，结果显示：3例为微小病变，5例为系膜增生性肾小球肾炎，3例为局灶增生性肾小球肾炎，1例为膜性肾小球肾炎。发病年龄与组织学类型之间无相关性，而临床数据与组织学受累程度密切相关。11例患者随访了5.16±3.2年（范围1至13年）；7例患者完全缓解，3例患者仅有镜下血尿和/或轻度蛋白尿，1例患者因肺部感染并发症死亡。我们的报告证实儿童狼疮性肾炎的病情演变比成人更有利。特别是我们的患者中，发病年龄在10岁之前的患者均未出现不良预后，这与之前报道的年幼儿童较高的死亡率和发病率形成对比。我们患者较好的预后不仅可能取决于不存在更严重的狼疮性肾炎类型即弥漫增生性肾小球肾炎，还可能取决于早期诊断和后续治疗。
