Pediatric Systemic Lupus Erythematosus Guidelines

Updated: May 06, 2022
  • Author: Marisa S Klein-Gitelman, MD, MPH; Chief Editor: Lawrence K Jung, MD  more...
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Guidelines Summary

The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative made the following recommendations for each class of childhood-onset lupus nephritis based on the International Society of Nephrology/Renal Pathology Society 2003 classification system. [26]

  • Class I: Treatment should be guided by other symptoms.

  • Class II: Should be treated initially with low-dose prednisone, a disease-modifying antirheumatic drug should only be added after three months of persistent proteinuria or prednisone dependency.

  • Class III/IV: Treatment with mycophenolate mofetil (MMF) or intravenous cyclophosphamide combined with corticosteroids; maintenance treatment MMF and/or azathioprine for at least three years.

  • Class V: MMF with low-dose prednisone can be used as induction, MMF as maintenance treatment.