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Review
. 2023 Oct 16;59(10):1841.
doi: 10.3390/medicina59101841.

Lupus Nephritis in Children: Novel Perspectives

Marco Pennesi  1 , Simone Benvenuto  2
Affiliations
Review

Lupus Nephritis in Children: Novel Perspectives

Marco Pennesi et al. Medicina (Kaunas). .

Abstract

Childhood-onset systemic lupus erythematosus is an inflammatory and autoimmune condition characterized by heterogeneous multisystem involvement and a chronic course with unpredictable flares. Kidney involvement, commonly called lupus nephritis, mainly presents with immune complex-mediated glomerulonephritis and is more frequent and severe in adults. Despite a considerable improvement in long-term renal prognosis, children and adolescents with lupus nephritis still experience significant morbidity and mortality. Moreover, current literature often lacks pediatric-specific data, leading clinicians to rely exclusively on adult therapeutic approaches. This review aims to describe pediatric lupus nephritis and provide an overview of the novel perspectives on the pathogenetic mechanisms, histopathological classification, therapeutic approach, novel biomarkers, and follow-up targets in children and adolescents with lupus nephritis.

Keywords: activity and chronicity index; belimumab; low disease activity; lupus nephritis; obinutuzumab; pediatric; systemic lupus erythematosus; urinary CD163; voclosporin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pathogenesis of lupus nephritis. ICs: immune complexes; GBM: glomerular basement membrane; IL-4: interleukin-4; TGF-β: transforming growth factor-beta; TNF: tumor necrosis factor; IFN-γ: interferon-gamma. Created with BioRender.com.
Figure 2
Figure 2
Therapeutic approach to active class III/IV alone or combined with class V LN. HCQ: hydroxychloroquine; IV: intravenous; MTP: methylprednisolone; PDN: prednisone; MMF: mycophenolate mofetil; CYC: cyclophosphamide; AZA: azathioprine; LN: lupus nephritis; RTX: rituximab.
See this image and copyright information in PMC

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