KIDNEY-DISEASE IN SYSTEMIC LUPUS-ERYTHEMATOSUS (SLE) OF CHILDREN - MORPHOMETRIC ANALYSIS OF KIDNEYS FROM AUTOPSY CASES

We have investigated the histopathological changes of kidney from 16 a utopsy cases of children with systemic lupus erythematosus (SLE) using morphometric and immunohistochemical methods. These 16 cases accounte d for 61% of the child autopsy cases with SLE registered in the data b ase ''Annual of the Pathological Autopsy Cases in Japan'' during the n ine years from 1984 to 1992. Based on the histologic and morphometric findings, we divided the SLE-associated renal disease into three types : glomerular (3 cases), vascular (3 cases) and non-renal (10 cases) ty pes. The glomerular and vascular types had renal lesions, while in the non-renal the main changes were found in extrarenal tissues. Of the 1 6 cases examined, three showed diffuse proliferative glomerulonephriti s, with one of the three having crescentic formations in the glomeruli . Two of the three had wire-loop lesions. Recently the crescentic or w ire-loop lesions are rarely experienced even in renal biopsy and autop sy of adult cases. The vascular type was characterized by necrotizing angiitis (1 case) and severe intimal thickening of interlobular arteri es (2 cases), but they had no advanced glomerular lesion. Morphometric methods allowed us to demonstrate that the severity of arterial lesio ns, especially intimal thickening, does not correlate with that of glo merular lesions in children.