儿科发病与成人发病狼疮性肾炎的临床和实验室差异:回顾性队列分析。

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI:10.1177/09612033251352706
Joanna Kosałka-Węgiel, Radosław Dziedzic, Andżelika Siwiec-Koźlik, Magdalena Spałkowska, Lech Zaręba, Stanisława Bazan-Socha, Mariusz Korkosz
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引用次数: 0

摘要

狼疮性肾炎(LN)是系统性红斑狼疮(SLE)的一种严重表现,具有显著的发病率和死亡率。然而,在更年轻的年龄发展的LN的过程是不太清楚。因此,我们评估了成人LN患者的临床和实验室特征,并根据疾病是在儿童期(儿科起病LN [pLN])还是在成年期(成人起病LN [aLN])开始进行比较。患者和方法回顾性分析2012年至2022年在波兰Kraków大学医院治疗的所有成年LN患者的医疗记录。所有纳入的患者都符合欧洲抗风湿病联盟/美国风湿病学会2019年的SLE标准。结果343例LN患者中有46例(13.41%)出现pLN。pLN和aLN的男女比例相对较高(分别为6.67 vs 4.82);P = 0.07),组织学上也同样表现为更晚期的肾脏受累。反过来,狼疮、疟疾疹和浆膜炎在pLN中比aLN更常见(p = 0.048和p = 0.015)。pLN患者出现终末期肾病(ESKD)的频率是前者的2.72倍(p = 0.036);然而,个人年增长率没有差异。有趣的是,在pLN中,我们报道了IgM类抗心磷脂抗体更常见的存在(p = 0.042)。其他sle特异性自身抗体的发生在两个分析组之间没有差异。关于免疫抑制治疗,糖皮质激素在两个亚组中都是最常用的。然而,与aLN患者相比,pLN患者使用氯喹或羟氯喹、硫唑嘌呤和免疫球蛋白的频率更高(p < 0.05)。结论spln以SLE临床表现更为严重为特点。因此,儿童期发生LN的SLE患者可能需要更积极的免疫抑制治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and laboratory differences in pediatric-onset versus adult-onset lupus nephritis: A retrospective cohort analysis.

IntroductionLupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE) and is associated with significant morbidity and mortality. However, the course of LN that develops at a younger age is less well understood. Therefore, we evaluated the clinical and laboratory characteristics of adult LN patients and compared them, depending on whether the disease started in childhood (pediatric-onset LN [pLN]) or in adulthood (adult-onset LN [aLN]).Patients and MethodsWe retrospectively analyzed the medical records of all adult LN patients treated at the University Hospital in Kraków, Poland, from 2012 to 2022. All included patients met the European League Against Rheumatism/American College of Rheumatology criteria for SLE from 2019.ResultsAmong 343 LN patients, pLN was stated in 46 cases (13.41%). pLN and aLN had a comparably high female-to-male ratio (6.67 vs 4.82, respectively; p = 0.07) and similarly often presented with more advanced kidney involvement in histology. In turn, lupus malar rash and serositis were more frequent in pLN than aLN (p = 0.048 and p = 0.015, respectively). End-stage kidney disease (ESKD) was documented in pLN patients 2.72 times more frequently (p = 0.036); however, the person-year rate did not differ. Interestingly, in pLN we reported a more common presence of anti-cardiolipin antibodies in the IgM class (p = 0.042). The occurrence of other SLE-specific autoantibodies did not differ between both analyzed groups. Regarding immunosuppressive treatment, glucocorticosteroids were the most frequently utilized in both subgroups. Still, pLN cases were more frequently treated with chloroquine or hydroxychloroquine, azathioprine, and immunoglobulins than aLN patients (p < 0.05, for all).ConclusionspLN is characterized by more severe SLE clinical manifestations. Therefore, SLE patients who developed LN in childhood likely require more aggressive immunosuppressive treatment.

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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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