Lupus nephritis in Chinese children--a territory-wide cohort study in Hong Kong.
We report a multicenter study of Chinese children in Hong Kong with systemic lupus erythematosus (SLE) nephritis. Children were included if: they fulfilled the ACR criteria, had significant proteinuria or casturia, were Chinese and younger than 19 years and had been diagnosed with SLE between January 1990 and December 2003. Investigators in each center retrieved data on clinical features, biopsy reports, treatment and outcome of these patients. There were 128 patients (eight boys, 120 girls; mean age: 11.9+/-2.8 years). About 50% presented with multisystem illness and 40% with nephritic/nephrotic symptoms. Negative anti-dsDNA antibodies were found in 6% of the patients. Renal biopsy revealed WHO Class II, III, IV and V nephritis in 13 (10%), 22 (17%), 69 (54%) and 13 (10%) patients, respectively. The clinical severity of the nephritis did not accurately predict renal biopsy findings. The follow-up period ranged from 1 to 16.5 years (mean+/-SD: 5.76+/-3.61 years). During the study five patients died (two from lupus flare, one from cardiomyopathy, two from infections). Four patients had endstage renal failure (ESRF) (one died during a lupus flare). All deaths and end-stage renal failure occurred in the Class IV nephritis group. Chronic organ damage was infrequent in the survivors. The actuarial patient survival rates at 5, 10 and 15 years of age were 95.3, 91.8, and 91.8%, respectively. For Class IV nephritis patients, the survival rates without ESRF at 5, 10, and 15 years were 91.5, 82.3 and 76%, respectively. The survival and chronic morbidity rates of the Chinese SLE children in the present study are comparable to those of other published studies.
Wong
Sik-Nin
SN
Department of Paediatrics & Adolescent Medicine, Tuen Mun Hospital, Tsing Chung Koon Road, Tuen Mun, Hong Kong, People's Republic of China. snwong@hkucc.hku.hk
Tse
Kei-Chiu
KC
Lee
Tsz-Leung
TL
Lee
Kwok-Wai
KW
Chim
Stella
S
Lee
Kwok-Piu
KP
Wai-Po Chu
Reann
R
Chan
Winnie
W
Fong
Kwok-Wah
KW
Hui
Joannie
J
Po-Siu Li
Samantha
S
Yeung
Pa-Shing
PS
Yuen
So-Fun
SF
Chi-Hang Ho
Assunta
A
Chuk-Kwan Leung
Lettie
L
Luk
David
D
Tong
Pak-Chiu
PC
Chan
Shu-Yan
SY
Cheung
Hon-Ming
HM
Chow
Chung-Mo
CM
Lau
David
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008181:Lupus Nephritis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D015996:Survival Rate