LUPUS NEPHRITIS IN CHILDREN IN A TERTIARY HOSPITAL: BANGLADESH PERSPECTIVE

 

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https://storage.unitedwebnetwork.com/files/1099/7a2460f95345b7f7b7d4b938990daa23.pdf
LUPUS NEPHRITIS IN CHILDREN IN A TERTIARY HOSPITAL: BANGLADESH PERSPECTIVE

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Abeer
Muntasir
Salma Jahan salmajahan@bsmmu.edu.bd BMU Paediatric Nephrology Dhaka Bangladesh -
Sabina Sultana sultanasm20@yahoo.com BMU Paediatric Nephrology Dhaka Bangladesh -
Amina Akter amina.nupur43@gmail.com BMU Paediatric Nephrology Dhaka Bangladesh -
Nadira Sultana nadira1412@bsmmu.edu.bd BMU Paediatric Nephrology Dhaka Bangladesh -
Sharmin Akter Luna sharminluna82@yahoo.com Goonoshastho Nagar Hospital Paediatric Nephrology Dhaka Bangladesh -
Samina Masud Santa santa023@yahoo.com BMU Paediatric Nephrology Dhaka Bangladesh -
Mst Shanjida Sharmim sharmim@bsmmu.edu.bd BMU Paediatric Nephrology Dhaka Bangladesh -
Abdullah Al Mamun mamunbdcn@gmail.com BMU Paediatric Nephrology Dhaka Bangladesh -
Tahmina Jesmin tahmina.jesmin@yahoo.com BMU Paediatric Nephrology Dhaka Bangladesh -
Shamsun Nahar shantabm8@gmail.com BMU Paediatric Nephrology Dhaka Bangladesh -
Syed Saimul Huque psaim@bsmmu.edu.bd BMU Paediatric Nephrology Dhaka Bangladesh -
Delwar Hossain delwar.pn@bsmmu.edu.bd BMU Paediatric Nephrology Dhaka Bangladesh -
Abeer Muntasir drabeermuntasir@gmail.com Anwer Khan Modern Medical College Medicine Dhaka Bangladesh *
Afroza Begum begumafroza@bsmmu.edu.bd Bangladesh Medical University Paediatric Nephrology Dhaka Bangladesh -
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Background

Renal involvement is the most important prognostic factor of Systemic Lupus Erythematosus (SLE). Renal involvement, its severity, treatment facilities, and outcome vary in different countries. As there are very few data on this regard from this region of the world, we prospectively studied the children with Lupus Nephritis(LN) who were admitted or visited in the out-patient department of the Department of Pediatric Nephrology, Bangladesh Medical University, Dhaka, Bangladesh.

We evaluated 197 children with lupus nephritis in our department from January 2017-July 2025. All patients fulfilled the Systemic Lupus International Collaborating Clinics (SLICC) criteria (2012) or ACR (2019) for the diagnosis of SLE and had evidence of renal involvement. Renal biopsy was done in 147 patient who gave consent. Renal histology was classified according to ISN-2003 criteria.

Mean age of presentation was 12.71±3 years and male to female ratio was 1:4.3. About sixty-two percent patients were from rural areas and 74% parents had monthly income below 198 US dollar/month. Most frequent presentation was different types of rashes (62%) , followed by arthritis(46.7%), oral ulcer(49.2%), photosensitivity (19.3%), serositis (66%), psychosis(4.6%) and seizure(5.9%). Positive ANA, anti DS DNA was present in 84.8% and 83.8% cases. Low C3 and C4 was present in 87.3% and 53.8% cases respectively. Leukopenia, lymphopenia, hemolytic anaemia and thrombocytopenia was present in 7.6%, 4.1%, 12.7% and 6.6% cases. Renal Presentation include hematuria (68%) and proteinuria (86.3%), Hypertension (44.7%) and impaired renal function (42.6%). Histologically mostly presented with class IV lupus nephritis (23.4%)

The Majority of the patients with lupus nephritis were from low socio-economic status and from rural areas. Proteinuria and hematuria were the main presenting features. Positive ANA, anti-DS DNA and hypocomplementaemia were the main immunological criteria. Class IV nephritis was the main histopathology.

Kewords