Glomerulonefrite o lúpus eritematoso sistêmico juvenil: perfil epidemiológico, clínico e terapêutico em um hospital terciário.

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic inflammatory and autoimmune disease that affects multiple systems. Juvenile Systemic Lupus Erythematosus (JSLE) associated with Lupus Nephritis (LN) is related to higher morbidity and mortality, and the histological type of LN determines the prognosis of renal involvement. Brazilian studies are still incipient on the profile of these patients. This study aimed to determine the epidemiological, clinical and therapeutic profile of patients with JSLE and LN in a tertiary hospital, in addition to evaluating the clinical outcome and disease activity. The research consisted of a transversal, retrospective, descriptive study. For inclusion, the patient should have the diagnosis of JSLE and LN between the period 2008 to 2018 by the criteria of the SLICC group. The analysis was done from a standardized form with charts of 25 patients who met the eligibility criteria. The majority were females (92%), mean

age at diagnosis of 13.84 years, and predominance of and blacks and brown- skinned (92%). Arthritis was the most frequent clinical criterion (72%) followed by

acute cutaneous lupus. In addition that 19 patients (76%) had proteinuria/24h greater than 1g, which may be associated with more severe renal impairment. Renal biopsy, performed in 11 patients, identified class IV as the most common (36%). Despite the clinical-histological correlation found in our sample, there is limited inference and renal biopsy remains the gold standard. There was no change in the treatment protocol of patients who had access to biopsy. Of the seven patients who needed an intensive care unit, four died. All deaths were due to septic shock and in 30% of patients it was not possible to calculate disease activity, which is an independent risk factor for infections. Epidemiological variables corroborated the literature, as the clinical outcome was similar to that already described in large studies. It is concluded that it is necessary to monitor the patient in a more objective way in order to reduce the amount of hospitalizations due to disease activity. The authors elaborated and suggested the use of a standard form of patient care with JSLE.