Research Article | | Peer-Reviewed

Association Between Clinical and Biochemical Findings of Pediatric Lupus Nephritis and Different Histological Classes

Received: 4 March 2025     Accepted: 19 April 2025     Published: 14 May 2025
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Abstract

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune inflammatory multisystem disorder which is higher in the pediatric patients than the adult counterpart. The proposed International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system 2018 stratifies the histomorphological findings of the renal biopsy specimens into different classes that correlates with the clinical and biochemical renal outcome. Methods: This was a cross-sectional observational study conducted at the Department of Pathology, BSMMU. The study included the clinically diagnosed cases of pediatric lupus nephritis, from March 2021 to January 2023. Patients were enrolled by consecutive sampling after fulfilling the inclusion and exclusion criteria. Light microscopy findings of the formalin fixed paraffin-embedded renal biopsy specimens were evaluated and recorded according to the proposed ISN/RPS classification system of LN, 2018. The data were recorded. Ethical measures were maintained throughout the study. The statistical analysis was carried out using the Statistical Package for Social Sciences version 22 for Windows (SPSS Inc., Chicago, Illinois, USA). Before starting this study, the research protocol was being approved by the IRB (Institutional Review Board) of BSMMU, Dhaka. Results: Among 80 patients of LN, majority (67.5%) of the patients belonged to age group 13 to 18 years. The mean age was 13.96 ± 3.09 years ranged from 6 to 18 years. 83.75% of patients were female and 16.25% were male. Class II LN was the most common histological class (32.5%), followed by class IV (27.5%). Majority (46.3%) of the LN patients presented with isolated proteinuria. No clinical presentation was associated with histomorphological classes of LN. UTP and serum creatine were found not significantly associated with histological class of pediatric lupus nephritis. Conclusion: In this study, Class II LN was found to be the most common class of lupus nephritis according to the modified ISN/RPS 2018 classification system.

Published in Clinical Medicine Research (Volume 14, Issue 2)
DOI 10.11648/j.cmr.20251402.12
Page(s) 37-43
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Systemic Lupus Erythematosus, Lupus Nephritis, Histomorphological, Proteinuria, Nephrotic Syndrome

References
[1] Venishetty, H. et al. (2019) ‘Clinicopathological spectrum of patients with lupus nephritis in a tertiary care hospital’, JMSR, 7(2), pp. 36-42.
[2] Oni, L. et al. (2017) ‘Inter-observer variability of the histological classification of lupus glomerulonephritis in children’, Lupus, 26(11), pp. 1205-1211. Available at:
[3] Pinheiro, S. V. B. et al. (2019) ‘Pediatric lupus nephritis’, Jornal brasileiro de nefrologia : ’orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia, 41(2), pp. 252-265. Available at:
[4] Baqui, M. N. et al. (2016) ‘A clinicopathological study on lupus nephritis; experience of 34 cases from Bangladesh.’, Journal of nephropharmacology, 5(1), pp. 19-23.
[5] Wenderfer, S. E. and Eldin, K. W. (2019) ‘Lupus Nephritis’, Pediatric Clinics of North America, 66(1), pp. 87-99. Available at:
[6] Hachiya, A. et al. (2021) ‘The ISN/RPS 2016 classification predicts renal prognosis in patients with first-onset class III/IV lupus nephritis’, Scientific Reports, 11(1), pp. 1-12. Available at:
[7] Srivastava, P. et al. (2016) ‘Outcome of lupus nephritis in childhood onset SLE in North and Central India: Single-centre experience over 25 years’, Lupus, 25(5), pp. 547-557. Available at:
[8] Hashmi, A. A. et al. (2020) ‘Spectrum of Morphologic Features of Lupus Nephritis According to Nephrology/Renal Pathology Society (ISN/RPS) Classification’, Cureus, 12(9), pp. 6-13. Available at:
[9] Begum, A. et al. (2021) ‘POS-221 Clinico-Pathological Profile of Children with Lupus Nephritis in A Tertiary Care Hospital’, Kidney International Reports, 6(4), p. S93. Available at:
[10] Hari, P. et al. (2009) ‘Outcome of lupus nephritis in Indian children’, Lupus, 18(4), pp. 348-354. Available at:
[11] G, B. et al. (2022) ‘Analysis of Clinicopathological Characteristics and Its Correlation With the Prognosis of Pediatric Lupus Nephritis: A Tertiary Care Center Experience’, Cureus, 14(2), pp. 1-8. Available at:
[12] H, V. et al. (2019) ‘Clinicopathological spectrum of patients with lupus nephritis in a tertiary care hospital’, Journal of Medical and Scientific Research, 7(2), pp. 36-42. Available at:
[13] Islam, S. M. J. et al. (2021) ‘Clinico-histomorphologic Characteristics of Lupus Nephritis, Experience at a Center at Dhaka’, Saudi Journal of Kidney Diseases and Transplantation, 32(6), pp. 1754-1763. Available at:
[14] Fahmi, N., Hameed, A. and Fliah, W. (2017) ‘Lupus Nephritis in Children Hospital Based Multicentre Study’, 16(2), pp. 198-204.
Cite This Article
  • APA Style

    Sermin, N., Nupur, F. P., Abedin, N., Paul, T., Papry, A., et al. (2025). Association Between Clinical and Biochemical Findings of Pediatric Lupus Nephritis and Different Histological Classes. Clinical Medicine Research, 14(2), 37-43. https://doi.org/10.11648/j.cmr.20251402.12

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    ACS Style

    Sermin, N.; Nupur, F. P.; Abedin, N.; Paul, T.; Papry, A., et al. Association Between Clinical and Biochemical Findings of Pediatric Lupus Nephritis and Different Histological Classes. Clin. Med. Res. 2025, 14(2), 37-43. doi: 10.11648/j.cmr.20251402.12

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    AMA Style

    Sermin N, Nupur FP, Abedin N, Paul T, Papry A, et al. Association Between Clinical and Biochemical Findings of Pediatric Lupus Nephritis and Different Histological Classes. Clin Med Res. 2025;14(2):37-43. doi: 10.11648/j.cmr.20251402.12

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  • @article{10.11648/j.cmr.20251402.12,
      author = {Nafisa Sermin and Farjana Pervin Nupur and Nafisa Abedin and Tanushree Paul and Afsana Papry and Fahmida Hasan Chowdhury and Rezwana Karim and Mumtahena Mahmuda and Nasrin Parvin Labani},
      title = {Association Between Clinical and Biochemical Findings of Pediatric Lupus Nephritis and Different Histological Classes
    },
      journal = {Clinical Medicine Research},
      volume = {14},
      number = {2},
      pages = {37-43},
      doi = {10.11648/j.cmr.20251402.12},
      url = {https://doi.org/10.11648/j.cmr.20251402.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20251402.12},
      abstract = {Introduction: Systemic lupus erythematosus (SLE) is an autoimmune inflammatory multisystem disorder which is higher in the pediatric patients than the adult counterpart. The proposed International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system 2018 stratifies the histomorphological findings of the renal biopsy specimens into different classes that correlates with the clinical and biochemical renal outcome. Methods: This was a cross-sectional observational study conducted at the Department of Pathology, BSMMU. The study included the clinically diagnosed cases of pediatric lupus nephritis, from March 2021 to January 2023. Patients were enrolled by consecutive sampling after fulfilling the inclusion and exclusion criteria. Light microscopy findings of the formalin fixed paraffin-embedded renal biopsy specimens were evaluated and recorded according to the proposed ISN/RPS classification system of LN, 2018. The data were recorded. Ethical measures were maintained throughout the study. The statistical analysis was carried out using the Statistical Package for Social Sciences version 22 for Windows (SPSS Inc., Chicago, Illinois, USA). Before starting this study, the research protocol was being approved by the IRB (Institutional Review Board) of BSMMU, Dhaka. Results: Among 80 patients of LN, majority (67.5%) of the patients belonged to age group 13 to 18 years. The mean age was 13.96 ± 3.09 years ranged from 6 to 18 years. 83.75% of patients were female and 16.25% were male. Class II LN was the most common histological class (32.5%), followed by class IV (27.5%). Majority (46.3%) of the LN patients presented with isolated proteinuria. No clinical presentation was associated with histomorphological classes of LN. UTP and serum creatine were found not significantly associated with histological class of pediatric lupus nephritis. Conclusion: In this study, Class II LN was found to be the most common class of lupus nephritis according to the modified ISN/RPS 2018 classification system.
    },
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Association Between Clinical and Biochemical Findings of Pediatric Lupus Nephritis and Different Histological Classes
    
    AU  - Nafisa Sermin
    AU  - Farjana Pervin Nupur
    AU  - Nafisa Abedin
    AU  - Tanushree Paul
    AU  - Afsana Papry
    AU  - Fahmida Hasan Chowdhury
    AU  - Rezwana Karim
    AU  - Mumtahena Mahmuda
    AU  - Nasrin Parvin Labani
    Y1  - 2025/05/14
    PY  - 2025
    N1  - https://doi.org/10.11648/j.cmr.20251402.12
    DO  - 10.11648/j.cmr.20251402.12
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 37
    EP  - 43
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20251402.12
    AB  - Introduction: Systemic lupus erythematosus (SLE) is an autoimmune inflammatory multisystem disorder which is higher in the pediatric patients than the adult counterpart. The proposed International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system 2018 stratifies the histomorphological findings of the renal biopsy specimens into different classes that correlates with the clinical and biochemical renal outcome. Methods: This was a cross-sectional observational study conducted at the Department of Pathology, BSMMU. The study included the clinically diagnosed cases of pediatric lupus nephritis, from March 2021 to January 2023. Patients were enrolled by consecutive sampling after fulfilling the inclusion and exclusion criteria. Light microscopy findings of the formalin fixed paraffin-embedded renal biopsy specimens were evaluated and recorded according to the proposed ISN/RPS classification system of LN, 2018. The data were recorded. Ethical measures were maintained throughout the study. The statistical analysis was carried out using the Statistical Package for Social Sciences version 22 for Windows (SPSS Inc., Chicago, Illinois, USA). Before starting this study, the research protocol was being approved by the IRB (Institutional Review Board) of BSMMU, Dhaka. Results: Among 80 patients of LN, majority (67.5%) of the patients belonged to age group 13 to 18 years. The mean age was 13.96 ± 3.09 years ranged from 6 to 18 years. 83.75% of patients were female and 16.25% were male. Class II LN was the most common histological class (32.5%), followed by class IV (27.5%). Majority (46.3%) of the LN patients presented with isolated proteinuria. No clinical presentation was associated with histomorphological classes of LN. UTP and serum creatine were found not significantly associated with histological class of pediatric lupus nephritis. Conclusion: In this study, Class II LN was found to be the most common class of lupus nephritis according to the modified ISN/RPS 2018 classification system.
    
    VL  - 14
    IS  - 2
    ER  - 

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Author Information
  • Department of Clinical Pathology, Dhaka Medical College Hospital, Dhaka, Bangladesh

  • Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh

  • Directorate General of Health Service, Dhaka, Bangladesh

  • Department of Pathology, MH Samorita Medical College and Hospital, Dhaka, Bangladesh

  • Department of Pathology, Sir Salimullah Medical College, Dhaka, Bangladesh

  • Department of Clinical Pathology, Dhaka Medical College Hospital, Dhaka, Bangladesh

  • Department of Pathology, US-Bangla Medical College and Hospital, Dhaka, Bangladesh

  • Department of Pediatrics, Chittagong Medical College Hospital, Dhaka, Bangladesh

  • National Hospital Chattogram and Sigma Lab Limited, Dhaka, Bangladesh

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