Research ArticleArticle
Approach to Membranous Lupus Nephritis: A Survey of Pediatric Nephrologists and Pediatric Rheumatologists
Alexis Boneparth, Suhas M. Radhakrishna, Larry A. Greenbaum, Eric Yen, Daryl M. Okamura, Jennifer C. Cooper, Sherene Mason, Deborah M. Levy, Sangeeta D. Sule, Paul T. Jensen, Cagri Yildirim-Toruner, Stacy P. Ardoin and Scott E. Wenderfer
The Journal of Rheumatology September 2017, jrheum.170502; DOI: https://doi.org/10.3899/jrheum.170502
Alexis Boneparth
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Suhas M. Radhakrishna
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Larry A. Greenbaum
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Eric Yen
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Daryl M. Okamura
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Jennifer C. Cooper
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Sherene Mason
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Deborah M. Levy
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Sangeeta D. Sule
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Paul T. Jensen
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Cagri Yildirim-Toruner
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Stacy P. Ardoin
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Scott E. Wenderfer
Columbia University Medical Center, New York, New York; Rady Children’s Hospital, University of California San Diego, San Diego; University of California Los Angeles, Los Angeles; University of California San Francisco, San Francisco, California; Children’s Healthcare of Atlanta, Emory University, Atlanta, Georgia; Seattle Children’s Hospital Research Institute, University of Washington, Seattle, Washington; Connecticut Children’s Hospital, University of Connecticut, Hartford, Connecticut; Johns Hopkins University, Baltimore, Maryland; Nationwide Children’s Hospital, The Ohio State University, Columbus, Ohio; Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, USA; Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. A. Boneparth, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Columbia University Medical Center; S.M. Radhakrishna, MD, Assistant Clinical Professor of Pediatrics, Pediatric Rheumatologist, Rady Children’s Hospital, University of California San Diego; L.A. Greenbaum, MD, PhD, Marcus Professor of Pediatrics, Pediatric Nephrologist, Children’s Healthcare of Atlanta, Emory University; E. Yen, MD, Pediatric Rheumatology Fellow, University of California Los Angeles; D.M. Okamura, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Seattle Children’s Hospital Research Institute, University of Washington; J.C. Cooper, MD, PharmD, Pediatric Rheumatology Fellow, University of California San Francisco; S. Mason, MD, MBA, Assistant Professor of Pediatrics, Pediatric Nephrologist, Connecticut Children’s Hospital, University of Connecticut; D.M. Levy, MD, MS, FRCPC, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Hospital for Sick Children, University of Toronto; S.D. Sule, MD, Associate Professor of Pediatrics, Pediatric Nephrologist, Johns Hopkins University; P.T. Jensen, MD, Pediatric and Adult Rheumatology Fellow, Nationwide Children’s Hospital, The Ohio State University; C. Yildirim-Toruner, MD, Assistant Professor of Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.P. Ardoin, MD, Associate Professor of Medicine and Pediatrics, Pediatric Rheumatologist, Nationwide Children’s Hospital, The Ohio State University; S.E. Wenderfer, MD, PhD, Assistant Professor of Pediatrics, Pediatric Nephrologist, Texas Children’s Hospital, Baylor College of Medicine. Address correspondence to Dr. A. Boneparth, Division of Pediatric Allergy, Immunology, and Rheumatology, Columbia University Medical Center, 622 West 168th St., New York, New York 10032, USA. E-mail: ab4459@cumc.columbia.edu. Accepted for publication July 14, 2017.
Abstract
Objective To describe treatment practices for childhood pure membranous lupus nephritis (MLN).
Methods Survey study of Childhood Arthritis and Rheumatology Research Alliance and American Society of Pediatric Nephrology members.
Results There were 117 respondents who completed the survey (60 pediatric nephrologists, 57 pediatric rheumatologists). Steroids and nonsteroid immunosuppression (NSI) were routinely used by the majority for MLN. Mycophenolate mofetil was the favored initial NSI. Nephrologists used steroids (60% vs 93%) and NSI (53% vs 87%) less often than did rheumatologists for MLN without nephrotic syndrome (NS).
Conclusion Pediatric rheumatologists and nephrologists both recommend steroids and NSI for children with MLN, with or without NS.
In this issue
The Journal of Rheumatology
Vol. 49, Issue 7
1 Jul 2022
Approach to Membranous Lupus Nephritis: A Survey of Pediatric Nephrologists and Pediatric Rheumatologists
Alexis Boneparth, Suhas M. Radhakrishna, Larry A. Greenbaum, Eric Yen, Daryl M. Okamura, Jennifer C. Cooper, Sherene Mason, Deborah M. Levy, Sangeeta D. Sule, Paul T. Jensen, Cagri Yildirim-Toruner, Stacy P. Ardoin, Scott E. Wenderfer
The Journal of Rheumatology Sep 2017, jrheum.170502; DOI: 10.3899/jrheum.170502
Approach to Membranous Lupus Nephritis: A Survey of Pediatric Nephrologists and Pediatric Rheumatologists
Alexis Boneparth, Suhas M. Radhakrishna, Larry A. Greenbaum, Eric Yen, Daryl M. Okamura, Jennifer C. Cooper, Sherene Mason, Deborah M. Levy, Sangeeta D. Sule, Paul T. Jensen, Cagri Yildirim-Toruner, Stacy P. Ardoin, Scott E. Wenderfer
The Journal of Rheumatology Sep 2017, jrheum.170502; DOI: 10.3899/jrheum.170502
