OUTCOME OF RENAL LESIONS IN SYSTEMIC LUPUS-ERYTHEMATOSUS

Clinical and biologic features, histologic findings, and outcome were studied in 32 children with systemic lupus erythematosus who underwent at least two renal biopsies during the course of their disease. Results showed that renal biopsy was a useful aid for therapy in that it demonstrated the presence or absence of disease activity, but was unhelpful for predicting the long term outcome. Repeat renal biopsies proved an excellent means for monitoring the course of the nephropathy. This study showed that the various patterns of glomerulonephritis seen in SLE may exhibit changes over time, with either improvement or progression. Regression of lesions was seen mainly after treatment, whereas progression was associated with renal or extrarenal exacerbations of the disease. The absence of clinical improvement may reflect transformation to histologic forms which are unresponsive to therapy.