Clinical characteristics and prognosis of diffuse proliferative lupus nephritis with thrombotic microangiopathy

Autor:	Haitao Zhang, Linling Li, Huimei Chen, Weixin Hu, Zhengzhao Liu, ZZ Liu
Rok vydání:	2010
Předmět:	Adult Male medicine.medical_specialty Pathology Thrombotic microangiopathy Adolescent medicine.medical_treatment Lupus nephritis urologic and male genital diseases Gastroenterology Young Adult Rheumatology Renal Dialysis Risk Factors Internal medicine medicine Humans Renal Insufficiency Child Survival rate Hematuria Retrospective Studies medicine.diagnostic_test Thrombotic Microangiopathies business.industry Retrospective cohort study Microangiopathic hemolytic anemia Middle Aged Prognosis medicine.disease Lupus Nephritis Thrombosis Survival Rate Proteinuria Treatment Outcome Hypertension Female Hemodialysis Renal biopsy business Follow-Up Studies
Zdroj:	Lupus. 19:1591-1598
ISSN:	1477-0962 0961-2033
Popis:	We retrospectively analyzed the clinicopathologic characteristics and prognosis of 33 patients with diffuse proliferative lupus nephritis (class IV LN) complicated with thrombotic microangiopathy (TMA). Eighty-one percent of patients had renal dysfunction (mean Scr 3.1 ± 2.0 mg/dl), among whom 42.4% needed acute hemodialysis. Nephrotic proteinuria, gross hematuria and hypertension were presented in 57.6%, 24.2% and 93.9% of the patients. Microangiopathic hemolytic anemia, serum anti-dsDNA and anticardiolipin antibodies were found in 60.6%, 75.8% and 33.3% of the patients. Renal biopsy showed IV-G in 75.8%, class IV with class V in 21.2%, and IV-S in 1.23% of the patients. Glomerular segmental necrosis, microthrombi, crescents and arteriolar thrombosis were found in 51.5%, 69.7%, 60.6% and 60.7% of the patients, respectively. The follow up was 1 to 101 months (median 13 months). Only 50% of patients showed response to treatment. Three patients died, 10 developed end-stage renal failure (ESRF). The 5-year patient and renal survival rate was 69.2% and 46.7%, respectively. Major risks for ESRF included: a need for acute dialysis on admission, no response to the treatment and high renal chronic index. The results showed that class IV lupus nephritis with TMA has high mortality and low renal survival.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::780deb7903d64b4ce91166f275ef3480 https://doi.org/10.1177/0961203310376523 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.