Thanh bên bài viết

PDF
Đã xuất bản: 2022-06-11
Số lượt xem tóm tắt: 144
Số lượt xem PDF: 150
DOI: https://doi.org/10.52852/tcncyh.v154i6.908
Số xuất bản
Tập 154 Số 6 (2022): Tập 154 số 6 E10
Chuyên mục
Các bài báo
Cách trích dẫn
Phuong, L. T., Thuy, N. T. D., Ngoc, N. T., Huy, N. N., Tu, T. M., & Huong, N. T. (2022). 9. Treatment outcomes of Pediatric Lupus Nephritis Class III and IV in National Children’s Hospital. Tạp Chí Nghiên cứu Y học, 154(6), 69-75. https://doi.org/10.52852/tcncyh.v154i6.908

9. Treatment outcomes of Pediatric Lupus Nephritis Class III and IV in National Children’s Hospital

Luong Thi Phuong, Nguyen Thi Dieu Thuy, Nguyen Thi Ngoc, Nguyen Ngoc Huy, Truong Manh Tu, Nguyen Thu Huong

Nội dung chính của bài viết

Tóm tắt

Treatment of lupus nephritis (LN) remains challenging. A prospective observational study on the children with newly diagnosed LN class III and IV from 9/2019 to 9/2021 intended to examine the efficacy of MMF with corticosteroids as induction therapy for pediatric lupus nephritis class III and IV. All patients received 3 days of pulse methylprednisolone followed by a tapering course of oral prednisone therapy in combination with Mycophenolate mofetil (MMF) 1200mg/m2/day (max 2g/day). Those with urine protein-creatinine ratio (uPCR) > 200mg/mmol and normal renal function after 1-month treatment received MMF and low dose Calcineurin Inhibitors (CNI). There were 57 children who were 75.4% females, 42.1% of children in class III, and 57.9% in class IV. The mean age was 10.88. 82.5% of patients r eceived Corticosteroid and MMF, and 10 children were treated with Corticosteroid, MMF, and CNI. Early responses at week 12 were achieved by 71.9%. The overall response was seen in 93.3% of patients after 6 months of therapy ( 42.2% complete response and 51.1% partial response). 2 patients (3.5%) had infections. MMF is effective in the treatment of children with proliferative lupus nephritis in induction therapy.

Chi tiết bài viết

Từ khóa

Lupus Nephritis, serum Albumin, urine protein-creatinine ratio, Mycophenolate mofetil.

Tài liệu tham khảo

1. Kamphuis S, Silverman ED. Prevalence and burden of pediatric-onset systemic lupus erythematosus. Nat Rev Rheumatol. 2010; 6(9): 538-546. doi:10.1038/nrrheum.2010.121.
2. Levy DM, Kamphuis S. Systemic Lupus Erythematosus in Children and Adolescents. Pediatr Clin North Am. 2012; 59(2): 345-364. doi:10.1016/j.pcl.2012.03.007.
3. Almutairi A, Alkathiri Z, Al-Mayouf SM. Combination of tacrolimus and mycophenolate mofetil in persistent proteinuria due to refractory childhood lupus nephritis. Int J Pediatr Adolesc Med. 2018; 5(3): 99-102. doi:10.1016/j.ijpam.2018.08.001.
4. Contreras G, Sosnov J. Role of Mycophenolate Mofetil in the Treatment of Lupus Nephritis. Clin J Am Soc Nephrol. 2007; 2(5): 879-882. doi:10.2215/CJN.02740707.
5. Moore RA, Derry S. Systematic review and meta-analysis of randomised trials and cohort studies of mycophenolate mofetil in lupus nephritis. Arthritis Res Ther. 2006; 8(6): R182. doi:10.1186/ar2093.
6. Dahlström Ö, Sjöwall C. The diagnostic accuracies of the 2012 SLICC criteria and the proposed EULAR/ACR criteria for systemic lupus erythematosus classification are comparable. Lupus. 2019; 28(6): 778-782. doi:10.1177/0961203319846388.
7. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. PEDIATRICS. 2004; 114(2): 555-576. doi:10.1542/peds.114.2.S2.555.
8. Schwartz GJ, Muñoz A, Schneider MF, et al. New Equations to Estimate GFR in Children with CKD. J Am Soc Nephrol JASN. 2009; 20(3): 629-637. doi:10.1681/ASN.2008030287.
9. Sinha R, Raut S. Pediatric lupus nephritis: Management update. World J Nephrol. 2014; 3(2): 16-23. doi:10.5527/wjn.v3.i2.16.
10. Pinheiro SVB, Dias RF, Fabiano RCG, Araujo S de A, Silva ACS e. Pediatric lupus nephritis. J Bras Nefrol. 2019; 41(2): 252-265. doi:10.1590/2175-8239-JBN-2018-0097.
11. Sahay M, Saivani Y, Ismal K, Vali PS. Mycophenolate versus Cyclophosphamide for Lupus Nephritis. Indian J Nephrol. 2018; 28(1): 35-40. doi:10.4103/ijn.IJN_2_16.
12. Sato V a. H, Marques IDB, Goldenstein PT, et al. Lupus nephritis is more severe in children and adolescents than in older adults. Lupus. 2012; 21(9): 978-983. doi:10.1177/0961203312443421.
13. Batinić D, Milošević D, Čorić M, Topalović-Grković M, Jelušić M, Turudić D. Lupus nephritis in Croatian children: clinicopathologic findings and outcome. Lupus. 2015; 24(3): 307-314. doi:10.1177/0961203314563133.
14. Appel GB, Contreras G, Dooley MA, et al. Mycophenolate Mofetil versus Cyclophosphamide for Induction Treatment of Lupus Nephritis. J Am Soc Nephrol JASN. 2009; 20(5): 1103-1112. doi:10.1681/ASN.2008101028.
15. Liu Z, Zhang H, Liu Z, et al. Multitarget therapy for induction treatment of lupus nephritis: a randomized trial. Ann Intern Med. 2015; 162(1): 18-26. doi:10.7326/M14-1030.
16. Ginzler EM, Dooley MA, Aranow C, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med. 2005; 353(21): 2219-2228. doi:10.1056/NEJMoa043731.
17. Feng X, Gu F, Chen W, et al. Mizoribine versus mycophenolate mofetil or intravenous cyclophosphamide for induction treatment of active lupus nephritis. Chin Med J (Engl). 2014; 127(21): 3718-3723.