[Lupus nephropathy in children. Based on the authors' caseload]

Area of Science:

• Pediatric Nephrology
• Immunology
• Rheumatology

Background:

• Lupus nephritis is a severe complication of systemic lupus erythematosus, particularly in children.
• Optimal treatment strategies for pediatric lupus nephritis remain an area of active research.
• Early intervention is crucial to prevent long-term renal damage.

Purpose of the Study:

• To evaluate the efficacy and safety of adding cyclophosphamide to oral 6-methyl-prednisolone in treating pediatric lupus nephritis.
• To compare treatment outcomes between patients receiving 6-methyl-prednisolone alone versus those receiving 6-methyl-prednisolone plus cyclophosphamide.

Main Methods:

• Retrospective study of 12 pediatric patients with lupus nephritis.
• Patients divided into two groups: Group 1 (oral 6-methyl-prednisolone alone) and Group 2 (oral 6-methyl-prednisolone plus cyclophosphamide).
• Comparison of clinical features, renal function, laboratory values, and World Health Organization renal pathology classification at admission and during follow-up.

Main Results:

• No significant baseline differences between groups in age, sex, clinical presentation, or renal pathology.
• Group 2 (cyclophosphamide + 6-methyl-prednisolone) demonstrated significantly better outcomes.
• Improved survival rates (p<0.05), enhanced proteinuria reduction (p<0.01), and better glomerular filtration rate (p<0.05) in Group 2.
• No significant adverse effects were noted with the addition of cyclophosphamide.

Conclusions:

• Addition of cyclophosphamide to oral 6-methyl-prednisolone is a valuable therapeutic strategy for pediatric lupus nephritis.
• This combination therapy significantly improves treatment prognosis and renal function in children with lupus nephritis.
• Further prospective studies are warranted to confirm these findings and optimize treatment protocols.