ANALYSES OF PEDIATRIC LUPUS NEPHRITIS: A 7-YEAR EXPERIENCE IN A TERTIARY CENTRE
Mahesha V*, Ritambhra N**, Joshi K, Surjit S***
PGIMER, Chandigarh.*, PGIMER, Chandigarh.**, Departments of Histopathology & Pediatrics.***
Lupus nephritis encompasses a wide range of parenchymal injuries and severity in pediatric age group. Better predictors of outcome are needed for patients diagnosed with lupus nephritis, so that an appropriate management strategy may be selected.

Objectives:

To study the activity and chronicity lesions of lupus nephritis in the age group of less than 12 years.

Materials & Methods:

A retrospective analyses of first renal biopsies of pediatric patients (<12 years) with lupus nephritis were chosen. Clinical and laboratory data were collected retrospectively. A detailed histologic analysis of kidney biopsies were performed on Hematoxylin Eosin, Periodic acid-schiff and masson's trichrome stained sections according to the new WHO classification system.

Results:

There were 148 patients with lupus nephritis in our institute in the last 7 years. Out of which 21 patients were in the age group of < 12 years (age range: 3 to 12 years) and the sex ratio was M:F = 1: 2.6. According to the new WHO classification, 5 patients belonged to Class III (M:F = 1:4) having activity range of 1-4 and chronicity range of 0-1, 13 patients belonged to Class IV (M:F = 1: 2.6) having activity range of 3-10 and chronicity range of 1-6, and 3 female patients to Class V lupus nephritis having activity range of 2-4 and chronicity range of 0-2. Active lesions like tuft necrosis, crescent formation, karrhyorexis was noticed in 5 of the pediatric patients.

Conclusions:

Pediatric lupus nephritis is more common in female patients and has severe forms of the diseases. Majority of them have Class IV with active lesions and carry poor prognosis.
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