Lupus & antiphospholipid syndrome
Expert collaborative evidence-based consensus for childhood lupus nephritis diagnosis and treatment: unifying clinical approach in Saudi Arabia
Methodological detailsevidence-based, e-Delphi, multidisciplinary working group, systematic literature search, two-round e-Delphi, ≥70% agreement required for inclusion, Oxford Level of Evidence and Grade of Recommendation
- Evidence-based, e-Delphi
- Multidisciplinary working group
- Systematic literature search
- Two-round e-Delphi
- ≥70% agreement required for inclusion
- Oxford Level of Evidence and Grade of Recommendation
Recommendations
As issued by the authors
Early evaluation for renal involvement in all children with systemic lupus erythematosus (cSLE) patients and timely biopsy, using the 2018 ISN/RPS classification with added histopathologic criteria
Prognostic targets: ≥25% proteinuria reduction at 3 months, ≥50% at 6 months, and <0.7 g/day at 12 months
Class I-II: corticosteroids (low-moderate dose), with DMARDs if needed
Proliferative lupus nephritis (LN): high-dose corticosteroids + MMF first-line, CYC as alternative; multi-target or biologic regimens for refractory disease
Pure membranous LN: corticosteroids + MMF preferred, other agents second-line
Adjuvant: HCQ, early ACEi/ARB, infection prevention, and ovarian protection during CYC
Original publication
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