Proven influenza infection in children results in substantial hospital resource utilization and morbidity. Nationwide, the median hospital costs may total 55 million dollars. Our data support the Advisory Committee on Immunization's recommendations to expand the use of influenza vaccine to children > 2 years of age.

Background. Membranous glomerulopathy accounts for 28% of the biopsy-proven systemic lupus erythematosus nephritis in paediatric patients at the time of first biopsy, yet minimal data are available regarding outcomes in this population. Methods. We present a retrospective analysis of 26 paediatric patients with World Health Organization class V lupus nephritis. Patients were subdivided based on renal biopsy findings into the following subclasses: 16 (63%) Va, 2 (9%) Vb, 7 (26%) Vc and 1 (4%) Vd. We evaluated outcomes of renal function and urine protein to creatinine ratio (UPr/UCr). Results. Mean follow-up time was 38.6 (AE22) months. Eight patients at presentation had a glomerular filtration rate (GFR) <90 ml/min/1.73 m 2 , six with Va and two with Vc. The initial presenting serum creatinine was predictive of renal function at last follow-up in class Va and Vb patients (P ¼ 0.002). Twenty-one of the 26 patients had GFR !90 ml/min/ 1.73 m 2 at last follow-up; the five patients with GFR <90 ml/min/1.73 m 2 were all lupus class Va. Cyclophosphamide (CTX) therapy did not demonstrate a significant improvement in outcome. The following parameters failed to predict GFR at last follow-up visit: blood pressure, C3, C4 and UPr/UCr. Conclusions. The initial creatinine in patients with classes Va and Vb lupus nephritis predicted follow-up renal function. We found no correlation with outcome based on therapy with CTX and/or mycophenolate mofetil.