scholarly journals Case report of a male child with lupus nephritis

2019 ◽  
Vol 7 (1) ◽  
pp. 220
Author(s):  
Richa . ◽  
Shashi Sharma ◽  
Pankaj Abrol
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Pediatric Patients ◽  
Late Onset ◽  
Male Child ◽  
Unknown Etiology ◽  
Childhood Onset ◽  
Autoimmune Inflammatory Disease ◽  
Schonlein Purpura ◽  
Author Report

Systemic lupus erythematosus is a chronic autoimmune inflammatory disease of unknown etiology that affects various organs, most frequently the skin, joints, kidneys, nervous, hematologic and cardiovascular systems. It affects females more often as compared to males. The kidneys are one of the most serious organs involved. Lupus nephritis may present as hypertension, proteinuria, and renal failure or it may also be asymptomatic. The recent reports suggest that childhood-onset lupus nephritis could be more severe than the late-onset disease. The occurrence of SLE in pediatric patients is very rare, especially in a male child. Here author report a case of an 8-year-old male child clinically misdiagnosed as a case of henoch schonlein purpura, who was thoroughly investigated and finally confirmed as a case of lupus nephritis.

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

Lupus ◽  
2012 ◽  
Vol 21 (9) ◽  
pp. 978-983 ◽  
Author(s):  
VAH Sato ◽  
IDB Marques ◽  
PT Goldenstein ◽  
LPF Carmo ◽  
LB Jorge ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Older Patients ◽  
Late Onset ◽  
Interstitial Fibrosis ◽  
Activity Index ◽  
Disease Activity Index ◽  
Female Gender ◽  
First Year ◽  
Childhood Onset

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.

scholarly journals Validation of the Lupus Nephritis Clinical Indices in Childhood-Onset Systemic Lupus Erythematosus

2016 ◽  
Vol 68 (2) ◽  
pp. 195-202 ◽  
Author(s):  
Rina Mina ◽  
Khalid Abulaban ◽  
Marisa S. Klein-Gitelman ◽  
Barbara A. Eberhard ◽  
Stacy P. Ardoin ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Childhood Onset ◽  
Systemic Lupus ◽  
Clinical Indices ◽  
Onset Systemic Lupus Erythematosus

scholarly journals Salivary Cytokines as Potential Diagnostic Biomarkers for Systemic Lupus Erythematosus Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zeineb Zian ◽  
Assia Bouhoudan ◽  
Nadira Mourabit ◽  
Gholamreza Azizi ◽  
Mohcine Bennani Mechita
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Unknown Etiology ◽  
Systemic Lupus ◽  
Diagnostic Biomarkers ◽  
Additional Information ◽  
Autoimmune Inflammatory Disease ◽  
Cytokine Levels ◽  
Variable Clinical Presentation ◽  
Significant Attention

Systemic lupus erythematosus (SLE) is a complex autoimmune inflammatory disease characterized by an unknown etiology and a highly variable clinical presentation. This clinical heterogeneity might be explained by dysregulation of tolerance to self and apoptotic mechanisms, overproduction of autoantibodies, and abnormal cytokine levels. Cytokine imbalance levels have been associated with disease activity and severity in SLE patients. In the last years, salivary cytokines related to SLE have gained significant attention and researchers have begun to focus on the identification of cytokines in the saliva of SLE patients using it as a diagnostic fluid for the inflammatory process underlying SLE. This review highlights and summarizes recent studies revealing the cytokines that have been identified in the saliva of individuals with SLE. Data reported and discussed in this report may provide useful additional information to better understand the mechanisms associated with the disease.

scholarly journals Class IV Lupus Nephritis in the Setting of Serologically Quiescent Disease and Normal Urine Sediment in a Patient with Late-Onset Systemic Lupus Erythematosus

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Benedicta Nnodum ◽  
Lauren Dudley
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Late Onset ◽  
The Body ◽  
Systemic Lupus ◽  
Urine Sediment ◽  
Reactive Protein ◽  
Normal Urine ◽  
Class Iv

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that may affect any organ of the body. Lupus nephritis (LN) is a frequent and serious complication of SLE. We report a case of an 80-year-old woman who was initially diagnosed with late-onset SLE and eventually developed LN in the setting of normal complements, double-stranded DNA, C-reactive protein, erythrocyte sedimentation rate, and urine sediment. She developed abnormal renal function (creatinine of 1.7 mg/dl) and mild proteinuria (1-2+) without hematuria. Renal biopsy showed class IV lupus glomerulonephritis, active and chronic. The patient was started on mycophenolate mofetil which led to improvement of proteinuria and stabilization of creatinine. The suspicion for LN in a patient with late-onset SLE should remain high when there is development of suspicious renal or urinary abnormalities even if laboratory values do not suggest high disease activity and urinary sediment is normal. To our knowledge, this is one of the oldest patients with biopsy-proven LN and late-onset SLE.

scholarly journals Cross-sectional study of plasma Axl, ferritin, IGFBP4 and sTNFR2 as biomarkers of disease activity in childhood-onset SLE: A study of the Pediatric Nephrology Research Consortium

Lupus ◽  
2021 ◽  
pp. 096120332110161
Author(s):  
Samar A Soliman ◽  
Anam Haque ◽  
Sherene Mason ◽  
Larry A Greenbaum ◽  
M John Hicks ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Plasma Concentrations ◽  
Pediatric Nephrology ◽  
Complement C3 ◽  
Protein Markers ◽  
Childhood Onset ◽  
Cross Sectional ◽  
Dsdna Antibody

Objective To evaluate the performance of 4 plasma protein markers for detecting disease activity in childhood-onset systemic lupus erythematosus (SLE) patients. Methods Eighty-three consecutive pediatric patients fulfilling ≥4 ACR criteria for SLE and twenty-five healthy controls were prospectively recruited for serological testing of 4 protein markers identified by antibody-coated microarray screen, namely Axl, ferritin, IGFBP4 and sTNFR2. SLE disease activity was assessed using SLEDAI-2000 score. Fifty-seven patients had clinically active SLE (SLEDAI score ≥4, or having a flare). Results The plasma concentrations of Axl and ferritin were significantly higher in patients with active SLE than inactive SLE. Plasma Axl levels were significantly higher in active renal versus active non-renal SLE patients. Levels of Axl, ferritin and IGFBP4 correlated significantly with SLEDAI scores. Levels of Axl, IFGBP4 and sTNFR2 inversely correlated with plasma complement C3 levels. Only plasma Axl and ferritin levels correlated with degree of proteinuria. These markers were more specific, but less sensitive, in detecting concurrent SLE activity than elevated anti-dsDNA antibody titer or decreased C3. Ferritin and IGFBP4 levels were more specific for concurrent active lupus nephritis than anti-dsDNA or C3. Plasma ferritin was the best monitor of global SLE activity, followed by C3 then Axl, while both Axl and C3 were best monitors of clinical lupus nephritis activity. Conclusion In childhood-onset SLE patients, plasma ferritin and Axl perform better than traditional yardsticks in identifying disease activity, either global or renal. The performance of these plasma markers should be explored further in longitudinal cohorts of SLE patients.

scholarly journals ASSESSING THE IMPACT OF LUPUS NEPHRITIS IN A CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS COHORT

2019 ◽  
Author(s):  
ANA PAULA SAKAMOTO ◽  
LIANA SOIDO TEIXEIRA E SILVA ◽  
ANA MARIA LOROÑO TERRAZAS ◽  
CLÁUDIO ARNALDO LEN ◽  
CLOVIS ARTUR ALMEIDA DA SILVA ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Childhood Onset ◽  
Systemic Lupus ◽  
The Impact ◽  
Onset Systemic Lupus Erythematosus

Hydroxychloroquine blood levels predicts flare in childhood-onset lupus nephritis

Lupus ◽  
2021 ◽  
pp. 096120332110625
Author(s):  
Verena Andrade Balbi ◽  
Clovis Artur Silva ◽  
Tatiana Nascimento Pedrosa ◽  
Rosa Maria Rodrigues Pereira ◽  
Lucia Maria de Arruda Campos ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Multiple Logistic Regression Analysis ◽  
Renal Involvement ◽  
Blood Levels ◽  
High Morbidity ◽  
Childhood Onset ◽  
Roc Curve Analysis ◽  
Pharmacy Refill ◽  
Increased Risk

Objective Low hydroxychloroquine (HCQ) blood levels are predictors of flare in adult lupus. Childhood-onset systemic lupus erythematosus (cSLE) has high morbidity with renal involvement in up to 80% of cases. The aim of this study is to determine the HCQ cut-off levels which predicts flare in childhood-onset lupus nephritis (LN). Methods Sixty LN patients on HCQ use for at least 6-months were prospectively evaluated at baseline (BL) and about 6-months later for cSLE flare and HCQ blood levels (ng/mL) measured by liquid chromatography-tandem mass spectrometry. Results There were 19 patients (32%) with flare, during the study with median SLEDAI increase of 4 (0–8). Median (IQR) BL HCQ levels of the flare group were lower compared to stable patients [557.5 (68.6–980.3) vs. 1061.9 (534.8–1590.0 ng/mL); p=0.012]. ROC curve analysis demonstrated that HCQ levels≤1075 ng/mL were associated with a 5.08 (95%CI 1.28-20.13; p=0.021) times increased risk of flare. Six-month HCQ levels revealed that most patients 24/54 (44%) had persistently low levels (≤1075) during follow-up. Among those, 11/24 (46%) had flare. Multiple logistic regression analysis including prednisone use, baseline SLEDAI-2K, adherence based on pharmacy refill and BL HCQ blood levels as possible predictors of flare revealed that only HCQ blood level was independently associated with flare (OR 0.999, 95%CI 0.998-1.0, p=0.013). Conclusions We demonstrated that HCQ blood cut-off level under 1075 ng/mL predicts flare in childhood-onset LN patients under prescribed HCQ dose of 4.0–5.5 mg/kg/day. We further observed that most of these patients have compliance issues reinforcing the need for a close surveillance particularly in those with levels below the defined cut-off.

Clinical and immunological aspects and outcome of a Brazilian cohort of 414 patients with systemic lupus erythematosus (SLE): comparison between childhood-onset, adult-onset, and late-onset SLE

Lupus ◽  
2015 ◽  
Vol 25 (4) ◽  
pp. 355-363 ◽  
Author(s):  
M M das Chagas Medeiros ◽  
M Campos Bezerra ◽  
F N Holanda Ferreira Braga ◽  
M R Melo da Justa Feijão ◽  
A C Rodrigues Gois ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Late Onset ◽  
Adult Onset ◽  
Childhood Onset ◽  
Systemic Lupus ◽  
Brazilian Cohort
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