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Prognosis of lupus membranous nephropathy in children
Authors:Sylvie Nathanson  Rémi Salomon  Bruno Ranchin  Marie-Alice Macher  Marie-Pierre Lavocat  Marie-Jeanne Krier  Véronique Baudouin  Christine Azéma  Brigitte Bader-Meunier  Georges Deschênes
Affiliation:1. Pediatric Unit, H?pital Mignot, 177 rue de Versailles, 78150, le Chesnay, France
2. Pediatric Nephrology Unit, H?pital Necker-Enfants Malades, 149 rue de Sévres, 75015, Paris, France
3. Pediatric Nephrology Unit, H?pital Edouard Herriot, 5 place Arsonval, 69437, Lyon, France
4. Pediatric Nephrology Unit, H?pital Robert Debré, 48 bd Serrurier, 75019, Paris, France
5. Pediatric Unit, H?pital Nord, av Albert Raimond, 42055, St Etienne, France
6. Pediatric Nephrology Unit, H?pital Brabois, rue Morvan, 54500, Vandoeuvre les Nancy, France
7. Pediatric Nephrology Unit, H?pital d’enfants, 330 av Grande Bretagne, 31059, Toulouse, France
8. Pediatric Unit, H?pital de Bicêtre, 78 rue du Général Leclerc, 94270, le Kremlin-Bicêtre, France
9. Pediatric Nephrology Unit, H?pital Armand-Trousseau, 26 avenue du dr Arnold-Netter, 75012, Paris, France
Abstract:
The occurrence of membranous nephropathy in pediatric series of systemic lupus erythematosus has been reported only rarely, probably due to a very low frequency. One hundred fifty-four children who were seen in 100 French pediatric centers between January 2002 and April 2005 were included. Fifteen (12 girls and three boys) out of the 81 (18.5 %) children with renal involvement presented histological features of membranous nephropathy. Their ages ranged from six to 15 years old (mean=11.3) at the age of SLE diagnosis and 8/15 children were of African origin. Isolated membranous nephropathy was observed in nine patients, of whom five patients displayed a complete recovery following immunosuppressive treatment. Associated proliferative lesions were observed on the first kidney specimen in two patients and in a further renal biopsy in four other patients, leading to a less favorable course of lupus nephropathy.
Keywords:Lupus nephropathy  Membranous nephropathy  Proliferative glomerulonephritis  Glucocorticoids  Immunosuppression  Renal biopsy
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