Asia Pacific Journal of Pediatric and Child Health

Abstract Ref Number = APCP735

Poster Presentation

ASSOCIATION BETWEEN STAGING OF RENAL BIOPSY AND SLEDAI SCORE IN CHILDREN WITH LN AT DR KARIADI HOSPITAL

Radita Kusumaningrum,Wistiani Wistiani,Omega Mellyana Department of Pediatrics Faculty of Medicine Diponegoro University Department of Pediatrics, Faculty of Medicine, Diponegoro UniversityDr Kariadi Hospital, Semarang, Indonesia

Background : Renal involvement occurs in 50% to 75% of childhood-onset systemic lupus erythematosus patients. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) use to evaluate activity of the disease. Histopathological severity of Lupus Nephritis (LN) do not always followed with severity of clinical features. This study aimed to identify association between histopathological finding and SLEDAI in LN patients. Material : This is a retrospective study of LN children who had done renal biopsy at Dr. Kariadi Hospital from 2014-2017 from 60 patients SLE. Data were obtained from medical records. Results : A total of 17 patients with 15 girls and 2 boys. The mean age of onset was 10.6 years (6.11-17.3 years). Diagnosis at onset were SLE (n=7), Nephrotic Syndrome (n=5), and LN (n=5). Blood pressure was classified at various stage; hypertension stage I (n=3), stage II (n=11), and normotension (n=3). Results of histopathological analysis were class II (n=5), class III (n=8), class IV (n=3), class V (n=1). Assessment of disease activity according to SLEDAI score were no activity (n=3), mild (n=6), moderate (n=5), high (n=0), and very high activity (n=3). Frequent manifestations from SLEDAI were pyuria (9/17), hematuria (7/17), and proteinuria (3/17). Crescents were found in six renal biopsies with SLEDAI score were no activity (n=1), mild (n=2), moderate (n=2), and very high activity (n=1). One case which has histopathological analysis class III with no SLEDAI activity developed end stage renal disease requiring routine hemodialysis. From chi-square test we found no significant association between severity of histopathological analysis and SLEDAI (p=0,191). Conclusions : Renal histopathology analysis is not correlated with Systemic Lupus Erythematosus Disease Activity Index in children with Lupus Nephritis.

Keywords: lupus nephritis renal biopsy SLEDAI crescent