Lupus nephritis is more severe in children and adolescents than in older adults


Autoria(s): Sato, V. A. H.; Marques, I. D. B.; Goldenstein, P. T.; Carmo, L. P. F.; Jorge, L. B.; Titan, S. M. O.; Barros, R. T.; Woronik, V.
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

21/10/2013

21/10/2013

2012

Resumo

Objective: To evaluate clinicopathological features and treatment response in patients with lupus nephritis (LN), comparing the childhood- and late-onset forms of the disease. Methods: We retrospectively analyzed clinical presentation, treatment and evolution in patients diagnosed with LN by renal biopsy between 1999 and 2008. Patients were grouped by age-<= 18 years (n = 23); and >= 50 years (n = 13)-and were followed for the first year of treatment. Results: The baseline features of the childhood- and late-onset groups, respectively, were as follows: mean age, 15 +/- 2 and 54 +/- 5 years; female gender, 87% and 92%; hypertension, 87% and 77%; Systemic Lupus Erythematosus Disease Activity Index, 29 +/- 9 and 17 +/- 7 (p = 0.002); estimated glomerular filtration rate (eGFR), 86 +/- 66 and 70 +/- 18 ml/min; concurrent SLE/LN diagnosis, 90% and 15% (p < 0.001); crescents on biopsy, 74% and 30% (p = 0.02); activity index on biopsy, 4.8 +/- 2.6 and 3.3 +/- 1.9 (p = 0.10); and interstitial fibrosis (> 10%), 39% and 61% (p = 0.08). Treatment consisted mainly of methylprednisolone, prednisone and intravenous cyclophosphamide, average cumulative doses being similar between the groups. After 12 months of treatment, the eGFR in the younger and older patients was 116 +/- 62 and 78 +/- 20 ml/min, respectively (p = 0.005). Three of the younger patients progressed to dialysis at 12 months, compared with none of the older patients. Conclusion: Childhood-onset LN seems to be more severe than is late-onset LN. Lupus (2012) 21, 978-983.

Identificador

LUPUS, LONDON, v. 21, n. 9, supl. 1, Part 1, pp. 978-983, AUG, 2012

0961-2033

http://www.producao.usp.br/handle/BDPI/35370

10.1177/0961203312443421

http://dx.doi.org/10.1177/0961203312443421

Idioma(s)

eng

Publicador

SAGE PUBLICATIONS LTD

LONDON

Relação

LUPUS

Direitos

closedAccess

Copyright SAGE PUBLICATIONS LTD

Palavras-Chave #LUPUS NEPHRITIS #RENAL SURVIVAL #SYSTEMIC LUPUS ERYTHEMATOSUS #CHILDHOOD-ONSET #SINGLE-CENTER #ERYTHEMATOSUS #AGE #CLASSIFICATION #FEATURES #DAMAGE #RHEUMATOLOGY
Tipo

article

original article

publishedVersion