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Journal of the Korean Society of Pediatric Nephrology 1999;3(1): 80-87.
소아 루프스 신염에 대한 기초 조사
민재홍, 백경훈, 박경미, 김정수, 하일수, 정해일, 김중곤, 최용
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 소아과학교실
3서울대학교 의과대학 소아과학교실
4서울대학교 의과대학 소아과학교실
5서울대학교 의과대학 소아과학교실
6서울대학교 의과대학 소아과학교실
7서울대학교 의과대학 소아과학교실
8서울대학교 의과대학 소아과학교실
The Basic Data Analysis of Lupus Nephritis in Children
Jae Hong Min, Kyung Hoon Paek, Kyung Mi Park, Jung Sue Kim, Il Soo Ha, Hae Il Cheong, Joong Gon Kim, Yong Choi
1Department of Pediatrics, Seoul National University, College of Medicine
2Department of Pediatrics, Seoul National University, College of Medicine
3Department of Pediatrics, Seoul National University, College of Medicine
4Department of Pediatrics, Seoul National University, College of Medicine
5Department of Pediatrics, Seoul National University, College of Medicine
6Department of Pediatrics, Seoul National University, College of Medicine
7Department of Pediatrics, Seoul National University, College of Medicine
8Department of Pediatrics, Seoul National University, College of Medicine
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ABSTRACT
Purposes : Renal involvement is a potentially serious complication of systemic lupus erythematosus (SLE). There have been only few studies of lupus nephritis in pediatric age. In this study, the clinical manifestations, pathologic findings, response to treatment, and clinical course of lupus nephritis in children were analyzed. And the results will provide basic data for future nation-wide prospective multi-center study. Methods . The medical records of 46 children clinically and pathologically diagnosed to have lupus nephritis at Seoul National University Children's Hospital during 1986 to 1997 were analyzed retrospectively.
Results : 1) The median age of diagnosis of lupus nephritis was 12.8 years ($2;years~;15year$ 8months), and the sex ratio was 1:2.5. 2) FANA($85.7%$), anti-ds-DNA antibody ($78.0%$), and malar rash ($60.8%$) were the most common findings among the classification criteria by ARA Decreased C3 was detected in $88.9%$ of patients. 3) Hematuria ($87.0%$) was the most common renal symptom, and WHO class IV lupus nephritis was identified in 41 cases by renal biopsy. 4) In most of patients, the disease activity was controlled relatively well with a single or combined therapy of prednisolone, azathioprine, or cyclophosphamide. The response revealed no difference according to the mode of treatment. 5) Infection, especially of Varicella-Zoster virus and candida, was the most common complication during the disease course.
Conclusion : The renal involvement was noted in $87.0%$ of childhood SLE, and $89.1%$ of renal lesions was WHO class IV lupus nephritis known to associated with poor long-term prognosis. So, aggressive treatment using immunosuppressants in the early disease course may be helpful to increase long-term prognosis of lupus nephritis. A prospective multi-center study is necessary to analyze the therapeutic efficacy of various treatment modalities.
Key words: SLE | Children | Clinical Manifestation | Treatment
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