Betül SÖZERİ, S. MİR, F. MUTLUBAS, S. ŞEN

Retrospective analysis of the outcome of pediatric lupus nephritis, single center study

Amaç: Bu çalışmanın amacı lupus nefritli hastaların tedavi yönetemlerini ve izlem sonuçlarını analiz etmektir. Yöntem ve Gereç: Kliniğimizde 1986-2006 yılları arasında tanı almış ve tedavi edilen 37 lupus hastasına retrospektif çalışma yapıldı. Bulgular: Ortalama tanı yaşı 13 ± 2,2 yıldı. Hastaların 26 (% 70,2)' sında böbrek tutulumu mevcuttu. İlk biyopsi anında proteinüri saptanan 15 (% 57.7) hastadan 4'ünde (%15.3) nefrotik düzeyde proteinüri vardı. 11(% 42.3) hastada hematüri, 7(% 26.9) hastada hipertansiyon ve 6 (23%) hastada renal fonksiyon bozukluğu saptandı. Lupus nefritinde histopatolojik bulgulardan evre II (% 42.3) en sık bulunurken, sırasıyla evre IV (% 30.7), evre III (15.3%) ve evre I (11.7%) saptandı. Tüm evre IV lupus nefritli hastalarda hipertansiyon ve nefrotik proteinuri anlamlı olarak yüksek saptandı. İzlem sonunda lupus nefriti olan hastaların %57'sinde remisyon varken %30 hasta aktif hastalık bulgularına sahipti. Sonuç: Sonuç olarak LN çocukların prognozu, primer olarak histopatolojik lezyonun şiddetine bağlıdır.

Pediatrik lupus nefritinin retrospektif izlem sonuçları, tek merkez çalışması

Aim: We aim to analyse in this study was outcome results and therapy modalities in patients with lupus nephritis. Materials and Methods: We performed a retrospective cohort study of our 37 lupus patients, diagnosed and treated between1986-2006. Conclusions: The mean age at onset of disease was 13 ± 2.2 years. Renal involvement was present in 26 (70.2%) of the patients. At the time of the initial biopsy, proteinuria was observed in 15 (57.7%) patients, and it was within nephrotic range in 4 (15.3%) patients. 11 (42.3%) patients had hematuria, 7 (26.9%) had hypertension, and 6 (23%) had impaired renal function. The most frequent histopathological finding was class II (42.3%), followed by class IV (30.7%), class III (15.3%) and class I (11.7%) lupus nephritis (LN). All patients with class IV lupus nephritis had a significant tendency for developing hypertension (p=0.006) and nephrotic range proteinuria (p=0.004). 57% of patients with lupus nephritis had remission, 30% of them still had active disease. Result: Finally, the prognosis of children with LN depends primarily on the severity of histopathological lesions.

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