Relationship Between Clinical Manifestation And Renal Pathology In Children With Lupus Nephritis

Objective:Clinical manifestation and renal pathological features of lupus nephritis in children werestatistically analyzed by using retrospective analysis method.Our study was to investigate therelationship between the two and provide theoretical basis for clinical diagnosis andtreatment.Methods:41cases of LN patients hospitalized were selected as the research object in the pediatricnephrology of the first hospital of Bethune jilin university from January2006to December2014, and renal biopsy were carried out within1~2weeks(The renal pathologic examinationincluded the light microscope and immunofluorescence detection).With the application ofmodern statistical methods,to carry on statistics analysis to its clinical manifestationrenal pathology,etc.Results:1. There are41cases of children in the study, of which8cases of male, female33cases;The sex ratio for these children was1:4.125.No significant difference between genders andrenal pathology classification existed (x2=5.242, P=0.263).The age was8to15years old, theaverage age was11.2±1.7; Children under the age of eight were2cases.No significantdifference between age segment and renal pathology classification existed (P=0.147).2.41cases of children with LN were associated with different clinical manifestations；They were different initial symptoms of disease,starting symptoms of abdominal pain in1case, rash in21cases, edema in18cases,13cases of hematuria, proteinuria in14cases, feverin16cases,6cases of joint swelling, headache in4cases.Other performances include hairloss, ulcers, and nervous system symptoms of change.Fever is the most common in theclinical datas of26cases (63.4%), followed by erythema20cases (48.8%), serositis, joint painwere14cases (34.1%), edema22case（s53.7%），oral ulcer17cases (41.5%),7cases (17.1%)of the nervous system, hair loss of17cases (41.5%).3. The datas according to the society of nephrology/renal pathology2002(ISN/RPS)setted the new standard of pathological grading is as follows: Ⅱlevel is3cases (7.3%), gradeⅢ is7cases (17.0%), grade Ⅳ%is29cases(70.3%), Ⅴl evel is1case (2.4%),Ⅳ﹢Ⅴl evel is1case (2.4%), of which the most common level is Ⅳlevel.4. The datas of41cases of children with LN kidney pathological immunofluorescencewere as follows: IgA deposit accounts for the number of cases for39cases (95.1%), IgM for39cases (95.1%), IgG for31cases (75.6%), C3to31cases (75.6%), C1qfor39cases (95.1%),F for38cases (92.7%);There are31cases (75.6%) appeared immunofluorescence werepositive for deposits.Immune complex sedimentaryIgA, IgM and IgG, C1q, F were most in41cases LN, the proportion is95.1%, followed by IgG, C3is75.6%. Statistically significantdifference between complex sedimentary IgA,IgM,IgG,C1q,F and renal pathologyclassification existed (x2=10.212, P=0.037x2=9.391, P=0.042, x2=13.543, P=0.009),prompting IgA, IgM and IgG, C1q, F deposition of immune complex between the pathologicalclassification of distribution is existed statistically significant.5.There are four types clinical classification in this study, the cases of isolationproteinuria type was6(14.6%),Acute nephritis model was21cases(51.2%), the nephriticsyndrome was13cases(31.7%),subclinical type1was1case(2.4%).6.In41cases of LN, there are mild proteinuria quantitation group for5cases (12.2%),11cases (26.8%) for moderate proteinuria quantitation group,25cases (61.0%) for severeproteinuria group.19cases with severe proteinuria quantitation group were the pathologicalgrading Ⅳlevel, clinical classification of moderately severe proteinuria group is givenpriority to with nephrotic syndrome, acute nephritis.Statistically significant differencebetween proteinuria and renal pathology classification existed (x2=12.407,P=0.015),prompting proteinuria between the pathological classification of distribution isexisted statistically significant. The higher proteinuria were deposited, the heavier kidney wasdamaged.7. In this study,the degree of activity of41cases were as follows: mild degree were2cases,moderate degree8cases, severe degree in31case.Statistically significant difference betweenactivity and renal pathology classification existed (F=13.080, P=0.011). The renalpathological damage was connected with the clinical manifestations in LN children.Conclusion:1.The renal pathological damage was not complete in parallel with the clinicalclassification in LN children.2.Clinical manifestation, sex, age inLN between kidney pathology classification have norelevance. 3. The proteinuria quantitation was closely related to the degree of kidney damage.4.There are many immune complex deposition LN.5. SLE activity was closely related to the degree of kidney damage.