Clinicopathological study of the WHO classification in childhood lupus nephritis.
Over the past 10 years, at our center, 25 children diagnosed with systemic lupus erythematosus (SLE) have undergone an early renal biopsy; 15 underwent a second biopsy. The objective of this study was to determine whether clinical and laboratory parameters used to evaluate lupus disease activity and nephritis correlated with the WHO class on biopsy. At diagnosis, the presence of proteinuria, hematuria, a lower serum albumin, and the need for blood pressure medication were all associated with a worse class of lupus nephritis ( P<0.05). On follow-up biopsy, however, none of these parameters correlated with the WHO class. Thus, it appears that while the WHO classification is useful for categorizing disease at presentation, it may be less useful for the evaluation of disease progression. Other biopsy indices need to be evaluated in serial renal biopsies to better understand the progression of lupus nephritis once treatment has been initiated.
Zappitelli
Michael
M
Department of Pediatrics, Division of Nephrology, McGill University Health Centre, Montreal Children's Hospital, Montreal, Canada.
Duffy
Ciaran
C
Bernard
Chantal
C
Scuccimarri
Rosie
R
Watanabe Duffy
Karen
K
Kagan
Rhoda
R
Gupta
Indra R
IR
D000293:Adolescent; D000477:Alkylating Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000963:Antimetabolites / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001706:Biopsy; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000145:classification* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome; D014944:World Health Organization
D000477:Alkylating Agents; D000893:Anti-Inflammatory Agents; D000963:Antimetabolites; D003520:Cyclophosphamide; D001379:Azathioprine; D011241:Prednisone