Clinical course of lupus membranous glomerulonephritis in children

被引：0
作者：
Iitaka K. [1 ,2 ]
Tomonaga K. [2 ]
Moriya S. [2 ]
Nakamura S. [2 ]
Motoyama O. [3 ]
机构：
[1] Department of Pediatrics, Yamato City Hospital, Kanagawa 242-8602
[2] Kitasato University Hospital, Sagamihara
[3] Toho University Hospital, Tokyo
来源：
Clinical and Experimental Nephrology | 2001年 / 5卷 / 3期
关键词：
Lupus nephritis; Membranous glomerulonephritis; Systemic lupus erythematosus;
D O I：
10.1007/s101570170003
中图分类号：
学科分类号：
摘要：
Background. Lupus nephritis (LN) is not a common renal disorder of childhood. Few pediatric nephrologists, except for those in a large center, see enough patients with LN to build up a substantial amount of experience. Membranous glomerulonephritis (MGN) associated with systemic lupus erythematosus (SLE), so-called lupus membranous glomerulonephritis (LMGN), is also rare in patients with LN. Methods. In 36 children with SLE, we investigated the clinical course of 4 children (1 boy and 3 girls) who showed MGN. Their mean age at presentation was 7.8 years and the mean follow-up period was 7.1 years. Results. Presenting symptoms were chance hematuria and proteinuria (H and P) in 2 children, edema in 1, and petechiae and thrombocytopenia in 1. The initial biopsy showed MGN in 3 children and diffuse proliferative glomerulonephritis in 1 child, in whom transition to MGN was observed. Two patients, who presented with chance H and P and showed MGN on the initial biopsy, later developed clinical signs of SLE, 3 and 5 years after presentation, respectively. During the course, all patients developed nephrotic syndrome, but at the last follow-up, H and P was detected in 1 child and proteinuria in 1 child. Urinalysis results were normal in 2 children. No patient had nephrotic syndrome or developed renal failure. Conclusions. The clinical course of LMGN in the 4 children seemed to be favorable. Two patients with MGN developed clinical signs of SLE several years after the renal manifestation.
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页码：153 / 157
页数：4
相关论文
共 17 条
  • [1] Cameron J.S., Lupus nephritis in childhood and adolescence, Pediatr Nephrol, 8, pp. 230-246, (1994)
  • [2] Lehman T.J.A., Amouradian J.A., Systemic lupus erythematosus, Pediatric nephrology, 3rd Ed., pp. 849-870, (1994)
  • [3] Platt J.L., Burke B.A., Fish A.J., Kim Y., Michael A.F., Systemic lupus erythematosus in the first two decades of life, Am J Kidney Dis, 2, pp. 212-222, (1982)
  • [4] Tan E.M., Cohen A.S., Fries J.F., Masi A.T., McShane D.J., Rothfield N.F., Et al., The 1982 revised criteria for the classification of systemic lupus erythematosus, Arthritis Rheum, 25, pp. 1271-1277, (1982)
  • [5] Iitaka K., Ishidate T., Hojo M., Kuwao S., Kasai N., Sakai T., Idiopathic membranoproliferative glomerulonephritis in Japanese children, Pediatr Nephrol, 9, pp. 272-277, (1995)
  • [6] Tochimaru H., Kuchikura K., Nagata Y., Takekoshi Y., Sakitama Y., Matsumoto Y., Et al., Clinical course of 29 children with SLE including renal biopsies in 21 patients, Jpn J Pediatr, 90, pp. 23-31, (1986)
  • [7] Garin E.H., Donnelly W.H., Fennell R.S., Richard G.A., Nephritis in systemic lupus erythematosus in children, J Pediatr, 89, pp. 366-371, (1976)
  • [8] Baqi N., Moazami S., Singh A., Ahmad H., Balachanda S., Tejani A., Lupus nephritis in children: A longitudinal study of prognostic factors and therapy, J Am Soc Nephrol, 7, pp. 924-929, (1996)
  • [9] Donadio J.V., Burger J.H., Holly K.E., Membranous lupus nephropathy: A clinicopathologic study, Medicine, 56, pp. 527-536, (1977)
  • [10] Baldwin D.S., Lowenstein J., Rothfield N.F., Gallo G., McClusky R.T., The clinical course of the proliferative and membranous forms of lupus nephritis, Ann Int Med, 73, pp. 929-942, (1970)
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