| Autor: |
Aiyegbusi O; Glasgow Renal and Transplant Unit, Queen Elizabeth University Teaching Hospital, Glasgow, UK. Oshorenua.Aiyegbusi@ggc.scot.nhs.uk., McGregor L; Glasgow Royal Infirmary, Glasgow, UK., McGeoch L; Glasgow Royal Infirmary, Glasgow, UK., Kipgen D; Pathology Department, Queen Elizabeth University Teaching Hospital, Glasgow, UK., Geddes CC; Glasgow Renal and Transplant Unit, Queen Elizabeth University Teaching Hospital, Glasgow, UK., Stevens KI; Glasgow Renal and Transplant Unit, Queen Elizabeth University Teaching Hospital, Glasgow, UK. |
| Jazyk: |
angličtina |
| Zdroj: |
Rheumatology and therapy [Rheumatol Ther] 2021 Mar; Vol. 8 (1), pp. 63-80. Date of Electronic Publication: 2020 Dec 24. |
| DOI: |
10.1007/s40744-020-00264-x |
| Abstrakt: |
Primary Sjögren's syndrome (pSS) is a chronic autoimmune disorder characterised by lymphocytic infiltration of the exocrine glands, predominantly the salivary and lacrimal glands, leading to sicca symptoms. Patients may have extraglandular disease involving multiple organs, including the kidneys. 5% of patients with pSS can have renal involvement. Kidney disease in pSS presents a diagnostic challenge, as clinical symptoms are often insidious and can precede sicca symptoms. pSS affects the kidney through lymphocytic infiltration of renal tubules or immune complex deposition, leading to an array of clinical features. Tubulointerstitial nephritis is the most common histological pattern of kidney disease. Other tubular injuries include renal tubular acidosis with hypokalaemia, Fanconi's syndrome and diabetes insipidus. Glomerular disease is less common and typically involves an immune complex-mediated process. Optimal treatment for kidney diseases in pSS is not established, and treatment is guided by the pattern of disease. For tubulointerstitial nephritis, management involves electrolyte imbalance correction and the use of immunosuppression, including steroids. Treatment of glomerular disease is targeted to the histological pattern, and often requires a combination of immunosuppressive agents. The risk of end-stage kidney disease is low. Nevertheless, patients with pSS and kidney disease have significantly reduced quality of life. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
|
