Association of Activity and Chronicity Indices With Clinical Presentation and Biochemical Parameters in Pediatric...

Background Systemic lupus erythematosus is an autoimmune inflammatory multisystem disorder, with the clinical presentation of childhood lupus nephritis varying widely. The underlying histological severity of pediatric lupus nephritis cannot always be predicted. Methodology This cross-sectional, observational study was conducted at the Department of Pathology, Bangladesh Medical University (BMU). The study included clinically diagnosed cases of pediatric lupus nephritis from March 2021 to January 2023. Patients were enrolled by consecutive sampling after fulfilling the inclusion and exclusion criteria. Light microscopy and immunofluorescence findings of the formalin-fixed paraffin-embedded renal biopsy specimens were evaluated and recorded. The statistical analysis was performed using SPSS version 22.0 for Windows (IBM Corp., Armonk, NY, USA). Results Among 80 patients with lupus nephritis, the majority (67.5%) belonged to the age group 13 to 18 years. The mean age was 13.96 ± 3.09 years, ranging from 6 to 18 years. Overall, 83.75% of patients were female, and 16.25% were male. Active lesions were more frequently seen (60%) than chronic lesions (12.5%). The majority (37.5%) of the patients presenting with isolated proteinuria showed the presence of activity indices. Patients with nephritic-nephrotic syndrome and isolated proteinuria (40% each) showed the presence of chronicity indices. However, no clinical features were significantly associated with activity and chronicity indices. Among the biochemical parameters, 24-hour urinary total protein was found to be significantly associated with the activity index. Conclusions In this study, a significant proportion of patients were female and in the adolescent age group. Urinary total protein was found to be significantly associated with the activity index. Four of the activity indices and one of the chronicity indices were found to be statistically significant.