Moumita Samanta1, Madhumita Nandi1, Rakesh Mondal2, Avijit Hazra3, Sumatra Sarkar4, Tapas Sabui5, Chanchal Kumar Kundu6, Arnab Biswas1. 1. Department of Pediatrics, NRS Medical College, Kolkata, India. 2. Department of Pediatrics, Medical College and Hospital, Kolkata, India. 3. Department of Pharmacology, IPGME&R SSKM Hospital, Kolkata, India. 4. Department of Pediatrics, IPGME&R SSKM Hospital, Kolkata, India. 5. Department of Pediatrics, RGKAR Medical College, Kolkata, India. 6. Department of Pediatrics, Chittaranjan Sishu Sadan Hospital, Kolkata, India.
Abstract
OBJECTIVE: To assess the long-term outcome of lupus nephritis in children with systemic lupus erythematosus followed up over 12 years at a tertiary care teaching hospital in Eastern India. MATERIAL AND METHODS: This is a retrospective observational study of the clinicopathological presentation, management, and outcome in 46 children with lupus nephritis over a period of 12 years at a tertiary teaching hospital in Eastern India. Mortality was compared between different lupus classes and therapy groups with Kaplan-Meier analysis and log-rank test. RESULTS: The incidence of lupus nephritis was 58.97% [95% confidence interval (CI) 48.06%-59.89%] with the mean age at presentation being 10.2±2.43 years (range 5.5-14.5) years. Majority belonged to class IV (30.43%), followed by class II (26.91%), class III (23.91), and class V (8.70%). Outcome analysis of children with lupus nephritis over 12 years revealed that 24 (52.17%) achieved complete remission of disease activity, 5 attained partial remission, 4 continued to have active disease, 5 developed end-stage renal disease (ESRD), and 8 died. Overall mortality thus observed was 17.39% with septicemia in the background of ESRD being the commonest cause. No significant difference in mortality was observed between different lupus nephritis classes or therapy arm groups. CONCLUSION: The study throws light on various aspects of lupus nephritis and their long-term outcome patterns in children from developing countries such as India.
OBJECTIVE: To assess the long-term outcome of lupus nephritis in children with systemic lupus erythematosus followed up over 12 years at a tertiary care teaching hospital in Eastern India. MATERIAL AND METHODS: This is a retrospective observational study of the clinicopathological presentation, management, and outcome in 46 children with lupus nephritis over a period of 12 years at a tertiary teaching hospital in Eastern India. Mortality was compared between different lupus classes and therapy groups with Kaplan-Meier analysis and log-rank test. RESULTS: The incidence of lupus nephritis was 58.97% [95% confidence interval (CI) 48.06%-59.89%] with the mean age at presentation being 10.2±2.43 years (range 5.5-14.5) years. Majority belonged to class IV (30.43%), followed by class II (26.91%), class III (23.91), and class V (8.70%). Outcome analysis of children with lupus nephritis over 12 years revealed that 24 (52.17%) achieved complete remission of disease activity, 5 attained partial remission, 4 continued to have active disease, 5 developed end-stage renal disease (ESRD), and 8 died. Overall mortality thus observed was 17.39% with septicemia in the background of ESRD being the commonest cause. No significant difference in mortality was observed between different lupus nephritis classes or therapy arm groups. CONCLUSION: The study throws light on various aspects of lupus nephritis and their long-term outcome patterns in children from developing countries such as India.
Authors: Cindy Flower; Anselm J M Hennis; Ian R Hambleton; George D Nicholson; Matthew H Liang Journal: Arthritis Care Res (Hoboken) Date: 2012-08 Impact factor: 4.794
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Authors: Helen E Foster; Christiaan Scott; Carl J Tiderius; Matthew B Dobbs Journal: Best Pract Res Clin Rheumatol Date: 2020-07-26 Impact factor: 4.098