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Presentation and outcome of paediatric membranous non-proliferative lupus nephritis

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Abstract

Background

Studies of paediatric patients with membranous lupus nephritis (MLN) have yielded variable results, mostly due to the inclusion of mixed, i.e. proliferative nephritis. The aim of this study was to describe clinical and laboratory findings at the diagnosis of paediatric non-proliferative MLN, report the outcome and identify predictors of remission.

Methods

A single-center cohort study of consecutive children diagnosed with non-proliferative MLN was performed. Clinical and laboratory measures and treatment regimens were obtained in prospective standardized assessments. Renal outcome was measured by renal parameters and steroid requirement. Predictors for remission and time to remission were determined.

Results

A total of 30 children were identified with a median follow-up time 4.1 years. Of 21 patients followed for more than 2 years, 19 (90 %) achieved clinical remission, and 16 (76 %) achieved a state of maintained clinical remission on low-dose prednisone. Three patients developed proliferative nephritis on subsequent renal biopsy. Lower albumin at the time of biopsy was correlated with a lower rate of remission and longer time to remission.

Conclusions

Among our paediatric patient cohort the outcome of non-proliferative MLN in systemic lupus erythematosus was good. The majority of patients did not require aggressive immunosuppressive treatment to reach a stable disease state on low-dose steroid treatment.

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Author information

Authors and Affiliations

  1. Division of Rheumatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    Boris Hugle, Earl D. Silverman, Pascal N. Tyrrell & Susanne M. Benseler

  2. Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    Elizabeth A. Harvey & Diane Hébert

  3. Department of Medical Imaging, University of Toronto, Toronto, Canada

    Pascal N. Tyrrell

  4. German Center for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany

    Boris Hugle

  5. Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    Susanne M. Benseler

  6. Section of Rheumatology, Department of Paediatrics, Alberta Children’s Hospital, University of Alberta, 2888 Shaganappi Trail, Calgary, T3B 2A8, Canada

    Susanne M. Benseler

Authors
  1. Boris Hugle
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  2. Earl D. Silverman
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  3. Pascal N. Tyrrell
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  4. Elizabeth A. Harvey
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  6. Susanne M. Benseler
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Correspondence to Susanne M. Benseler.

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Hugle, B., Silverman, E.D., Tyrrell, P.N. et al. Presentation and outcome of paediatric membranous non-proliferative lupus nephritis. Pediatr Nephrol 30, 113–121 (2015). https://doi.org/10.1007/s00467-014-2908-2

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  • DOI: https://doi.org/10.1007/s00467-014-2908-2

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