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Review
. 2014 May 6;3(2):16-23.
doi: 10.5527/wjn.v3.i2.16.

Pediatric lupus nephritis: Management update

Rajiv Sinha  1 , Sumantra Raut  1
Affiliations
Review

Pediatric lupus nephritis: Management update

Rajiv Sinha et al. World J Nephrol. .

Abstract

Childhood-onset systemic lupus erythematosus (cSLE) is a severe multisystem autoimmune disease. Renal involvement occurs in the majority of cSLE patients and is often fatal. Renal biopsy is an important investigation in the management of lupus nephritis. Treatment of renal lupus consists of an induction phase and maintenance phase. Treatment of childhood lupus nephritis using steroids is associated with poor outcome and excess side-effects. The addition of cyclophosphamide to the treatment schedule has improved disease control. In view of treatment failure using these drugs and a tendency for non-adherence, many newer agents such as immune-modulators and monoclonal antibodies are being tried in patients with cSLE. Trials of these novel agents in the pediatric population are still lacking making a consensus in the management protocol of pediatric lupus nephritis difficult.

Keywords: Cyclophosphamide; Lupus nephritis; Management; Monoclonal antibody; Mycophenolate mofetil; Pediatric.

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Figures

Figure 1
Figure 1
Class III/IV lupus nephritis induction therapy. MMF: Mycophenolate mofetil; CYC: Cyclophosphamide; GC: Glucocorticoids; iv: Intravenous; AZA: Azathioprine; BSA: Body surface area.
Figure 2
Figure 2
Treatment of class V without proliferative changes and with nephrotic range proteinuria (> 3 g/24 h). MMF: Mycophenolate mofetil; AZA: Azathioprine; CYC: Cyclophosphamide; GC: Glucocorticoids.
See this image and copyright information in PMC

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