Clinical and pathological analysis on children with lupus nephritis

LI Hai; LIU Hong-quan

Abstract：Toimprovetheclinicalunderstandingandtreatmentoflupusnephritis(LN)inchildren,toinvesti-gate the relationship between pathological classification and clinical manifestation of LN,and therapeutic responses. Methods:To retrospectively analyze patients with LN before18years of age,during 1990 -2000 year in hospital. The renal biopsy was made in 47 patients with LN. Pathological classification was based upon the stan-dard criteria of World Health Organism (WHO)1982,and scored their active index(AI),chronic index(CI). To investigate clinical manifestation and pathological features and therapeutic results. Results:Type Ⅳ was nost common(53. 2%),typeⅡ(19. 1%)amd tupeⅤ(19. 1%)were next. Type Ⅱ usually manifested as hematuria and/or proteinuria,on the other hand,severe proteinuria was found in Ⅳ,Ⅲtype LN. InⅣ type LN,there was high incidence of hypertension and extrarenal anifestations,and a highest AI. Ninety-three percent of the patients were treated with corticosteroids and pulse cyclophosphamide. The mean follow-up was(41. 6 ± 29. 7) months,the rate of remission was 88. 4%. The remission was higher and the time to remission was short inⅡ,Ⅳ type than inⅢ,Ⅴ type LN. Conclusion:A positive correlation is demonstrated between pathological classification and clinical manifesta-tions of LN,pathological classification could be foretold according to the clinical manifestation and necessary laboratory parame-ters. Renal biopsy is important in diagnosis of active status,in designing of therapeutic regimen and predicting of prognosis in LN.