Abstract
Silent LN has been reported in adults (Med. 56:493, 1977). In order to determine its occurrence in children with SLE, 10 who were diagnosed during the past 18 months underwent renal biopsy at the time of diagnosis. Six of 10 had no evidence of renal disease by urinalysis, creatinine clearance, or 24-hour protein excretion, and they are the basis of this report. The mean age was 12 years. The mean duration from onset of symptoms to biopsy was 4 months. Four of 6 had low C3, 5 of 6 had elevated DNA binding, and 3 of 6 received prednisone prior to biopsy. All biopsies had > 10 glomeruli. All had histologic changes on light microscopy: 5 had mesangial proliferation and one had diffuse proliferative LN. On fluorescent microscopy, 4 of 5 had IgG and 5 of 5 had C3 along capillary loops; 3 of 5 had IgG and 3 of 5 had C3 in the measngium. On electron microscopy, 4 of 6 had mesangial deposits, one had subepithelial and 2 had subendothelial deposits. Mean follow-up was 7 months. Renal function has been preserved in all, but 2 have developed overt nephritis. Analyses of clinical and laboratory data do not distinguish these 6 children from the other 4 presenting with overt nephritis.
Conclusions: 1) Silent LN occurs in childhood as well as in adult SLE. 2) The commonest histologic appearance is diffuse mesangial proliferation with a varying pattern of immune deposits. 3) Findings from early biopsy may be important in planning management and assessing prognosis.
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Kennedy, T., Schwartz, W., Cornfeld, D. et al. 1080 SILENT LUPUS NEPHRITIS (LN) IN CHILDREN. Pediatr Res 12 (Suppl 4), 544 (1978). https://doi.org/10.1203/00006450-197804001-01086
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DOI: https://doi.org/10.1203/00006450-197804001-01086