Rituximab Combining With Low-Dose Mycophenolate Mofetil on Proliferative Lupus Nephritis in Children

Inclusion criteria

• Children aged 3-18 years old, regardless of sex;
• SLE patients who meet the 2019 EULAR/ACR SLE criteria or the 2012 SLICC diagnostic criteria;
• Diagnosed as lupus nephritis and the classification was consistent with proliferative lupus nephritis (type III or IV, with or without type V);
• White blood cell count ≥3.0×10^9/L, and lymphocyte count ≥ 0.5× 10^9/L and CD20 (or CD19)≥1/ul;
• No cyclophosphamide or rituximab induction therapy was used before enrollment;
• Informed consent form is signed by the guardian and children over 8 years old;
• In the active stage of the disease, the 24-hour urine protein quantification ≥25mg/kg, or the urine protein/creatinine ≥1.0mg/mg;
• Estimated GFR≥60ml/min/1.73m^2 (improved Swchartz formula).

Exclusion criteria

• Patients with lupus encephalopathy;
• Estimated GFR<60ml/min/1.73m^2(Swchartz formula);
• HBV-antigen positive, HCV or HIV antibody positive;
• Severe infection (including chronic hepatitis, EB virus or cytomegalovirus infection) and tuberculosis;
• Allergic to the active ingredients or any auxiliary materials in rituximab, mycophenolate mofetil or cyclophosphamide;
• Severe heart failure and liver function damage;
• Patients who is not suitable to participate in this study judged by the researchers.