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Lupus Nephritis (Including Antiphospholipid Antibody Syndrome), Pediatric

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Glomerulonephritis

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Abstract

Childhood-onset systemic lupus erythematosus (cSLE) has been defined as a subset of SLE with onset prior to 18 years of age. Around 15% of SLE patients present with nephritis before this age, and debatably these patients have a greater genetic component to their disease etiology, a more systemic involvement, and a more severe disease course. Patients develop their loss of tolerance to self at an earlier time than patients with adult-onset SLE, or at least their loss of tolerance progresses sooner to immune complex deposition and tissue injury. In this chapter, we review the joint approach of pediatric nephrologists and rheumatologists towards patients with cSLE and nephritis. We address the areas where evidence exists and the areas where we must rely on expert opinion or evidence based on primarily adult studies. Fortunately, 5- and 10-year mortality is lower than in adult-onset lupus nephritis, and patient and renal survival has improved over the years. However, relapses during the transition from adolescence to adulthood are common and cardiovascular and infectious complications are frequent in long-term survivors.

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Authors and Affiliations

  1. Pediatric Nephrology, Baylor College of Medicine, Houston, TX, USA

    Scott E. Wenderfer

  2. Renal, Texas Children’s Hospital, 1102 Bates Avenue, Ste. 245, 77030, Houston, TX, USA

    Scott E. Wenderfer

  3. Pediatric Rheumatology, Medical University of South Carolina, 135 Rutledge Avenue, MSC 561, 29425, Charleston, SC, USA

    Natasha M. Ruth

Authors
  1. Scott E. Wenderfer
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  2. Natasha M. Ruth
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Correspondence to Scott E. Wenderfer .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, NYU Langone Medical Center, New York, New York, USA

    Howard Trachtman

  2. Hospital of the Univ. of Pennsylvania, Philadelphia, Pennsylvania, USA

    Jonathan J. Hogan

  3. Cleveland Clinic, Cleveland, Ohio, USA

    Leal Herlitz

  4. Nephrology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA

    Edgar V. Lerma

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Wenderfer, S.E., Ruth, N.M. (2018). Lupus Nephritis (Including Antiphospholipid Antibody Syndrome), Pediatric. In: Trachtman, H., Hogan, J., Herlitz, L., Lerma, E. (eds) Glomerulonephritis. Springer, Cham. https://doi.org/10.1007/978-3-319-27334-1_15-1

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  • DOI: https://doi.org/10.1007/978-3-319-27334-1_15-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27334-1

  • Online ISBN: 978-3-319-27334-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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