Systemic lupus erythematosus is a very variable and pleomorphic disease. Lupus nephritis with clinical manifestation appears in 65-70% of patients, kidney morphological changes are observed in 80-100%. In this study we analysed clinical course of lupus nephritis in 15 children treated between 1989-1998 (10 girls, 5 boys, aged 9.5-16 years). The following data were considered: inherited susceptibility to the disease, the first symptoms, primary diagnosis, the symptoms at admission to clinical hospital, the time from first symptoms to diagnosis of lupus, laboratory results, clinical course, treatment, outcome of disease. All children underwent percutaneous renal biopsy. 2 patients had class II, 7 patients--class III, 5--class IV and 1 class V of lupus nephritis. In the treatment were used: oral prednisone, intravenous methylprednisolone, methylprednisolone pulse, cyclophosphamide (oral and i.v.), sandimmum. Total or partial remission with normal renal function was observed in 11 children, 1 had stable renal insufficiency, 1 with terminal renal insufficiency started regular HD treatment, 2 patients died.
Conclusions: Lupus nephritis appears the main in young girls aged 12-15 years; the children with renal symptoms need of early renal biopsy and individual treatment; the prognosis of children with IV class lupus nephritis, severe anaemia, low complement, active urinary sediment and quick progress of renal insufficiency is poor.