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Membranous lupus nephritis in Chinese children—a case series and review of the literature

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Abstract

We retrospectively reviewed the cases of 13 lupus nephritis children with pure membranous glomerulonephritis (MGN; Group A) and ten children with mixed proliferative and membranous nephritis (Group B). The children were identified through a territory-wide survey of patients between 1990 and 2003. All were ethnic Chinese. Age at diagnosis ranged from 3.7 to 18.6 years (Group A) and from 9.6 to 22.1 years (Group B). Female-to-male ratios were 12:1 (Group A) and 9:1 (Group B). Group A patients were more often nephrotic than Group B patients (11/13 vs. 5/10, p = 0.17). The glomerular filtration rate (GFR) at presentation was normal in all but two patients (one from each group). For induction, Group B patients consistently received prednisolone and cyclophosphamide; in contrast, the cytotoxic regimens in Group A patients varied from cyclophosphamide (five patients), mycophenolate mofetil (two patients), azathiorpine plus cyclosporine (one patient), and azathioprine alone (one patient). After a median follow-up of 7.6–7.8 years, one Group A patient had died of fulminant lupus. One survivor in Group B had a GFR < 90 ml/min per 1.73 m2. Proteinuria persisted in five Group A patients and two Group B patients. In conclusion, Group B patients had good prognosis in terms of survival and proteinuria control. The only death occurred in Group A, and five of the 12 survivors in this group had persistent proteinuria. Further studies are needed to define the best treatment for pure lupus MGN.

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Acknowledgements

We would like to thank the chiefs-of-service of the participating paediatric departments for their support and their extending their approval for us to review the clinical data of their patients.

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Authors and Affiliations

  1. Department of Paediatrics & Adolescent Medicine, Tuen Mun Hospital, Tsing Chung Koon Road, Tuen Mun, Hong Kong, China

    Sik-Nin Wong

  2. Department of Paediatrics & Adolescent Medicine, Queen Elizabeth Hospital, Hong Kong, China

    Winnie Kwai-Yu Chan

  3. Department of Paediatrics & Adolescent Medicine, Prince of Wales Hospital, Hong Kong, China

    Joannie Hui

  4. Department of Paediatrics & Adolescent Medicine, Queen Mary Hospital, Hong Kong, China

    Stella Chim & Tsz-Leung Lee

  5. Department of Paediatrics & Adolescent Medicine, Alice Homiuling Nethersole Hospital, Hong Kong, China

    Kwok-Piu Lee

  6. Department of Paediatrics & Adolescent Medicine, Kwong Wah Hospital, Hong Kong, China

    Lettie Chuk-Kwan Leung

  7. Department of Paediatrics & Adolescent Medicine, Princess Margaret Hospital, Hong Kong, China

    Niko Kei-Chiu Tse

  8. Department of Paediatrics & Adolescent Medicine, Pamela Youde Eastern Nethersole Hospital, Hong Kong, China

    So-Fun Yuen

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  1. Sik-Nin Wong
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Correspondence to Sik-Nin Wong.

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Wong, SN., Chan, W.KY., Hui, J. et al. Membranous lupus nephritis in Chinese children—a case series and review of the literature. Pediatr Nephrol 24, 1989–1996 (2009). https://doi.org/10.1007/s00467-009-1257-z

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  • DOI: https://doi.org/10.1007/s00467-009-1257-z

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