Clinical Presentation of Renal Involvement in Juvenile Systemic Lupus Erythematosus in a Cohort of 48 Patients

Abstract

Introduction: Renal involvement in juvenile Systemic Lupus Erythematosus Erythematosus (jSLE) has been associated with high mortality rates. In addition, the clinical presentation in these patients is heterogeneous and conditions the prognosis of the disease.

Objective: To describe the clinical presentation of renal involvement in a cohort of patients with juvenile systemic lupus erythematosus.

Methods: We retrospectively analyzed the renal clinical characteristics of patients under 18 years of age in a single hospital center in the city of Guayaquil between 2018 - 2023 with a diagnosis of SLEj using the SLICC 2012 and American College of Rheumatology criteria.

Results: A total of 48 patients were included, with a mean age of 10.75 ± 2.78 years. The average number of hospital admissions was 4.40 (± 2.85). 68.8% presented renal manifestations, of which, the most frequent were nephrotic syndrome (48.5%) and followed by nephritic syndrome with 27.3%. The most common laboratory finding was proteinuria (48.4%), followed by hematuria (36.4%). Antinuclear antibodies (ANA) were positive in 90% of cases. The mortality rate was 10.4% and there was a significant association (p=0.01) with facial edema and oliguria.

Conclusion: This s tudy h ighlights the prevalence of renal manifestations, particularly nephrotic syndrome in pediatric patients with systemic lupus erythematosus, underlining the clinical relevance and the need for early surveillance. The significant association between mortality and symptoms such as facial edema and oliguria highlights their role as predictors of renal damage, considering also the higher female propensity.