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Background <p>Systemic lupus erythematosus (SLE) is a rare but severe autoimmune disease in children, with neurological involvement reported in 22–95% of cases and contributing significantly to morbidity and mortality. This study aimed to assess the prevalence and characteristics of neuropsychiatric manifestations in pediatric patients with lupus nephritis.</p> Methods <p>A retrospective multicenter study was conducted in four university hospitals in France, including pediatric patients with biopsy-confirmed lupus nephritis between 2020 and 2024. Clinical, biological, radiological, and treatment data were analyzed.</p> Results <p>Among the 23 included patients (74% female, median age 11&#xa0;years), six presented neurological manifestations. All had significant proteinuria (median 2.12&#xa0;g/g) and most had acute kidney injury (AKI). Lupus nephritis was predominantly class IV. Neurological symptoms varied widely, from headaches and attention deficits to catatonia and stroke. MRI findings included hyperintensities and atrophy in 50% of cases. No significant differences were observed between groups in univariate analyses. Given the limited number of neurological events, multivariable analyses were considered exploratory; in this context, AKI was associated with neurological involvement.</p> Conclusion <p>Neurological involvement affects at least one-quarter of children with lupus nephritis and may be underdiagnosed. Systematic, standardized screening is essential for early detection and tailored treatment.</p> Graphical abstract <p></p>

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Assessment of the prevalence of neurological involvement in a pediatric cohort of children with lupus nephritis: retrospective multicenter study

  • 期刊论文

  • 发表日期：

    2026年4月8日

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  • Mathilde Dutilloy,
  • Ferielle Louillet,
  • Marie Brasseur-Daudruy,
  • Robert Novo,
  • Henri Giniès,
  • Gwenaelle Roussey,
  • Hortense Petat

摘要

Background

Systemic lupus erythematosus (SLE) is a rare but severe autoimmune disease in children, with neurological involvement reported in 22–95% of cases and contributing significantly to morbidity and mortality. This study aimed to assess the prevalence and characteristics of neuropsychiatric manifestations in pediatric patients with lupus nephritis.

Methods

A retrospective multicenter study was conducted in four university hospitals in France, including pediatric patients with biopsy-confirmed lupus nephritis between 2020 and 2024. Clinical, biological, radiological, and treatment data were analyzed.

Results

Among the 23 included patients (74% female, median age 11 years), six presented neurological manifestations. All had significant proteinuria (median 2.12 g/g) and most had acute kidney injury (AKI). Lupus nephritis was predominantly class IV. Neurological symptoms varied widely, from headaches and attention deficits to catatonia and stroke. MRI findings included hyperintensities and atrophy in 50% of cases. No significant differences were observed between groups in univariate analyses. Given the limited number of neurological events, multivariable analyses were considered exploratory; in this context, AKI was associated with neurological involvement.

Conclusion

Neurological involvement affects at least one-quarter of children with lupus nephritis and may be underdiagnosed. Systematic, standardized screening is essential for early detection and tailored treatment.

Graphical abstract