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Updated: Aug 11, 2025

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Hydroxychloroquine in children with proliferative lupus nephritis: a randomized clinical trial

Fatma Sayed Gheet1, Heba El-Sayed Dawoud1, Waleed Ahmed El-Shahaby1

  • 1Pediatric Department, Faculty of Medicine, Tanta University, El-Geesh Street, Tanta, 31527, Egypt.

European Journal of Pediatrics
|February 8, 2023
PubMed

Insights

Hydroxychloroquine (HCQ) improved lupus nephritis in children, reducing disease activity and improving kidney function. While generally safe, some patients experienced mild skin and eye side effects.

Area of Science:

  • Pediatric Rheumatology
  • Nephrology
  • Pharmacology

Background:

  • Hydroxychloroquine (HCQ) is an established treatment for systemic lupus erythematosus (SLE) manifestations.
  • Limited research exists on HCQ's efficacy and safety in pediatric lupus nephritis (LN).

Purpose of the Study:

  • To evaluate the efficacy and safety of HCQ as an add-on therapy in children with proliferative lupus nephritis.
  • To assess HCQ's impact on disease activity, renal function, and adverse events.

Main Methods:

  • A 12-month, double-blind, randomized, placebo-controlled trial involving 60 children with proliferative LN (classes III and IV).
  • Patients received standard care (steroids and mycophenolate mofetil) plus either HCQ or a placebo.
  • Evaluations included clinical assessments, laboratory tests (BUN, creatinine, proteinuria, lipids, autoantibodies, complement), and ophthalmological examinations.

Main Results:

  • The HCQ group showed significant reductions in triglycerides, cholesterol, 24-hour proteinuria, anti-dsDNA levels, and SLE disease activity index (SLEDAI) scores after 12 months.
  • Higher rates of partial and complete LN remission were observed in the HCQ group (60%) compared to the placebo group (36.7%).
  • Adverse events like alopecia, hyperpigmentation, and mild retinal changes occurred in a small percentage of the HCQ group, with no significant difference from placebo.

Conclusions:

  • HCQ is an effective adjunctive treatment for pediatric proliferative lupus nephritis, improving clinical and laboratory parameters.
  • HCQ demonstrates favorable effects on lipid profiles and kidney function in this pediatric cohort.
  • The safety profile of HCQ in children with LN is acceptable, with rare instances of mild skin and ocular side effects.

Keywords:
ChildrenEfficacyHydroxychloroquineLupus nephritisSide effects

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