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09:43
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Pediatric lupus nephritis: more options, more chances?
1Department of Pediatrics, Prince of Songkla University, Songkla 90110,Thailand. vprayong@gmail.com
Lupus
|May 1, 2013
Summary
Lupus nephritis (LN) is a severe kidney disease in childhood systemic lupus erythematosus (SLE). Current treatments improve survival but long-term remission and safety remain challenges for pediatric patients.
Area of Science:
- Pediatric Nephrology
- Rheumatology
- Immunology
Background:
- Lupus nephritis (LN) presents more severely in childhood-onset systemic lupus erythematosus (SLE) compared to adults.
- LN is a primary cause of acute kidney injury (AKI) and chronic kidney disease (CKD) in children.
- Steroid therapy, introduced in 1970, has significantly improved SLE patient survival from 50% to over 80%.
Purpose of the Study:
- To review the current landscape of lupus nephritis treatment in pediatric SLE.
- To evaluate the effectiveness and safety of various immunosuppressive therapies.
- To highlight the challenges in achieving long-term remission and managing comorbidities.
Main Methods:
- Review of historical and current immunosuppressive treatments for pediatric LN.
- Analysis of survival rates and treatment outcomes from published studies.
- Consideration of drug benefits, adverse events, and patient-specific factors.
Main Results:
- Combination therapies with prednisolone (e.g., cyclophosphamide, mycophenolate mofetil, rituximab, tacrolimus) have increased survival rates to 90%-95%.
- Long-term disease remission remains a challenge, with many treatments showing initial efficacy but lacking sustained results.
- Fatal infections are a significant complication of aggressive chemotherapy regimens.
Conclusions:
- Optimizing treatment for pediatric SLE and LN requires balancing efficacy with safety and managing diverse patient factors.
- Developing safe and effective long-term maintenance therapies is crucial for sustained remission.
- Personalized combination therapies are likely necessary to improve outcomes for children with this debilitating disease.
Keywords:
Cyclophosphamidelupus nephritismycophenolate mofetilsystemic lupus erythematosus (SLE)therapyMore Related Videos
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