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Clinicopathological study of the WHO classification in childhood lupus nephritis

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Abstract

Over the past 10 years, at our center, 25 children diagnosed with systemic lupus erythematosus (SLE) have undergone an early renal biopsy; 15 underwent a second biopsy. The objective of this study was to determine whether clinical and laboratory parameters used to evaluate lupus disease activity and nephritis correlated with the WHO class on biopsy. At diagnosis, the presence of proteinuria, hematuria, a lower serum albumin, and the need for blood pressure medication were all associated with a worse class of lupus nephritis (P<0.05). On follow-up biopsy, however, none of these parameters correlated with the WHO class. Thus, it appears that while the WHO classification is useful for categorizing disease at presentation, it may be less useful for the evaluation of disease progression. Other biopsy indices need to be evaluated in serial renal biopsies to better understand the progression of lupus nephritis once treatment has been initiated.

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Acknowledgements

The authors would like to thank Elise Mok and Isabelle Morin for assistance in statistical methods and software usage, the Medical Records Department of the Montreal Children’s Hospital, and Dr. Atul Sharma for valuable feedback in the preparation of the manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Nephrology, McGill University Health Centre, Montreal Children’s Hospital, Montreal, Canada

    Michael Zappitelli & Indra R. Gupta

  2. Department of Pediatrics, Division of Rheumatology, McGill University Health Centre, Montreal Children’s Hospital, Montreal, Canada

    Ciaran Duffy, Rosie Scuccimarri, Karen Watanabe Duffy, Karen Watanabe Duffy & Rhoda Kagan

  3. Department of Pediatrics, Division of Pathology, McGill University Health Centre, Montreal Children’s Hospital, Montreal, Canada

    Chantal Bernard

  4. Division of Pediatric Nephrology, Montreal Children’s Hospital, 2300 Tupper, Room E-222, Montreal, Quebec, H3H 1P3, Canada

    Indra R. Gupta

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  1. Michael Zappitelli
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  2. Ciaran Duffy
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  3. Chantal Bernard
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Correspondence to Indra R. Gupta.

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Zappitelli, M., Duffy, C., Bernard, C. et al. Clinicopathological study of the WHO classification in childhood lupus nephritis. Pediatr Nephrol 19, 503–510 (2004). https://doi.org/10.1007/s00467-004-1419-y

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  • DOI: https://doi.org/10.1007/s00467-004-1419-y

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