Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India
Context: Systemic lupus erythematosus is an autoimmune multisystem disease with a high predilection for renal involvement. Lupus nephritis develops in 20% to 75% within the first two years. Presentation varies from subnephrotic proteinuria to end-stage renal disease. Aims: To study clinical features...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-01-01
|
| Series: | Indian Journal of Pathology and Microbiology |
| Subjects: | |
| Online Access: | http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2020;volume=63;issue=3;spage=397;epage=404;aulast=Basu |
| _version_ | 1819007045660049408 |
|---|---|
| author | Keya Basu Subhrajyoti Karmakar Moumita Sengupta Arpita Roychowdhury Alakendu Ghosh Manimoy Bandopadhyay |
| author_facet | Keya Basu Subhrajyoti Karmakar Moumita Sengupta Arpita Roychowdhury Alakendu Ghosh Manimoy Bandopadhyay |
| author_sort | Keya Basu |
| collection | DOAJ |
| description | Context: Systemic lupus erythematosus is an autoimmune multisystem disease with a high predilection for renal involvement. Lupus nephritis develops in 20% to 75% within the first two years. Presentation varies from subnephrotic proteinuria to end-stage renal disease. Aims: To study clinical features, biochemical, and serological parameters and correlate with histological activity and chronicity score [modified National Institute of Health (NIH) score]. Settings and Design: Retrospective, cross-sectional, single-center based study in a tertiary care hospital of Eastern India. Subjects and Methods: We incuded 36 children with lupus nephritis diagnosed from February 2018 to March 2019. Laboratory data included were complete blood count (CBC), blood glucose, urine analysis, serum urea, creatinine, blood urea nitrogen (BUN), albumin, cholesterol, HBsAg, antihepatitis C virus (HCV) antibody, antistreptolysin O (ASO) titer, antinuclear antibody (ANA), myeloperoxidase antineutrophil cytoplasmic antibody (MPO ANCA), proteinase 3 antineutrophil cytoplasmic antibody (PR3 ANCA), double-stranded DNA (dsDNA), C3, and C4. Clinical parameters were age, sex, blood pressure (BP), skin lesions, arthralgia, edema, obesity. Renal biopsies examined with light microscopy, hematoxylin and eosin (H and E), periodic acid-Schiff (PAS), silver methanamine, Masson's trichrome (MT) stains. Immunofluorescence microscopy done with IgG, IgM, IgA, C3c, C1q, kappa, lambda antibodies. Statistical Analysis Used: Kruskal–Wallis and χ2 tests. Results: Mean age was 15.12 ± 3.49 and 12.5 ± 1.73 years for lupus nephritis (LN) with activity and LN without activity, respectively. Mean dsDNA was higher and mean C3 was lower (52.35 ± 22.21 mg/dl) in active LN. Mean 24-hour urinary protein was higher in LN without activity. Serum creatinine was raised in active LN. LN class III and IV showed higher activity than chronicity. Conclusions: Pediatric LN is proliferative and more active as compared with adult counterparts. Activity scores are much higher than chronicity scores. |
| first_indexed | 2024-12-21T00:18:20Z |
| format | Article |
| id | doaj.art-dff0a846463f4ecdb9fa1f9ce44486b8 |
| institution | Directory Open Access Journal |
| issn | 0377-4929 |
| language | English |
| last_indexed | 2024-12-21T00:18:20Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Pathology and Microbiology |
| spelling | doaj.art-dff0a846463f4ecdb9fa1f9ce44486b82022-12-21T19:22:10ZengWolters Kluwer Medknow PublicationsIndian Journal of Pathology and Microbiology0377-49292020-01-0163339740410.4103/IJPM.IJPM_995_19Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern IndiaKeya BasuSubhrajyoti KarmakarMoumita SenguptaArpita RoychowdhuryAlakendu GhoshManimoy BandopadhyayContext: Systemic lupus erythematosus is an autoimmune multisystem disease with a high predilection for renal involvement. Lupus nephritis develops in 20% to 75% within the first two years. Presentation varies from subnephrotic proteinuria to end-stage renal disease. Aims: To study clinical features, biochemical, and serological parameters and correlate with histological activity and chronicity score [modified National Institute of Health (NIH) score]. Settings and Design: Retrospective, cross-sectional, single-center based study in a tertiary care hospital of Eastern India. Subjects and Methods: We incuded 36 children with lupus nephritis diagnosed from February 2018 to March 2019. Laboratory data included were complete blood count (CBC), blood glucose, urine analysis, serum urea, creatinine, blood urea nitrogen (BUN), albumin, cholesterol, HBsAg, antihepatitis C virus (HCV) antibody, antistreptolysin O (ASO) titer, antinuclear antibody (ANA), myeloperoxidase antineutrophil cytoplasmic antibody (MPO ANCA), proteinase 3 antineutrophil cytoplasmic antibody (PR3 ANCA), double-stranded DNA (dsDNA), C3, and C4. Clinical parameters were age, sex, blood pressure (BP), skin lesions, arthralgia, edema, obesity. Renal biopsies examined with light microscopy, hematoxylin and eosin (H and E), periodic acid-Schiff (PAS), silver methanamine, Masson's trichrome (MT) stains. Immunofluorescence microscopy done with IgG, IgM, IgA, C3c, C1q, kappa, lambda antibodies. Statistical Analysis Used: Kruskal–Wallis and χ2 tests. Results: Mean age was 15.12 ± 3.49 and 12.5 ± 1.73 years for lupus nephritis (LN) with activity and LN without activity, respectively. Mean dsDNA was higher and mean C3 was lower (52.35 ± 22.21 mg/dl) in active LN. Mean 24-hour urinary protein was higher in LN without activity. Serum creatinine was raised in active LN. LN class III and IV showed higher activity than chronicity. Conclusions: Pediatric LN is proliferative and more active as compared with adult counterparts. Activity scores are much higher than chronicity scores.http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2020;volume=63;issue=3;spage=397;epage=404;aulast=Basuactivitychronicitylupus nephritispediatricproliferativesystemic lupus erythematosus |
| spellingShingle | Keya Basu Subhrajyoti Karmakar Moumita Sengupta Arpita Roychowdhury Alakendu Ghosh Manimoy Bandopadhyay Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India Indian Journal of Pathology and Microbiology activity chronicity lupus nephritis pediatric proliferative systemic lupus erythematosus |
| title | Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India |
| title_full | Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India |
| title_fullStr | Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India |
| title_full_unstemmed | Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India |
| title_short | Pediatric lupus nephritis – An evil cousin of its adult counterpart: A single-center based experience from a tertiary care hospital of Eastern India |
| title_sort | pediatric lupus nephritis an evil cousin of its adult counterpart a single center based experience from a tertiary care hospital of eastern india |
| topic | activity chronicity lupus nephritis pediatric proliferative systemic lupus erythematosus |
| url | http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2020;volume=63;issue=3;spage=397;epage=404;aulast=Basu |
| work_keys_str_mv | AT keyabasu pediatriclupusnephritisanevilcousinofitsadultcounterpartasinglecenterbasedexperiencefromatertiarycarehospitalofeasternindia AT subhrajyotikarmakar pediatriclupusnephritisanevilcousinofitsadultcounterpartasinglecenterbasedexperiencefromatertiarycarehospitalofeasternindia AT moumitasengupta pediatriclupusnephritisanevilcousinofitsadultcounterpartasinglecenterbasedexperiencefromatertiarycarehospitalofeasternindia AT arpitaroychowdhury pediatriclupusnephritisanevilcousinofitsadultcounterpartasinglecenterbasedexperiencefromatertiarycarehospitalofeasternindia AT alakendughosh pediatriclupusnephritisanevilcousinofitsadultcounterpartasinglecenterbasedexperiencefromatertiarycarehospitalofeasternindia AT manimoybandopadhyay pediatriclupusnephritisanevilcousinofitsadultcounterpartasinglecenterbasedexperiencefromatertiarycarehospitalofeasternindia |