This is a retrospective study of the clinicopathological characteristics of 50 systemic lupus erythematosus patients with nephritis who underwent a kidney biopsy and were admitted to the American U...

Lupus nephritis in Lebanon.

Objective
To determine clinical features of different histopathological presentations in patients with lupus nephritis (LN).

Methods
Clinical and pathological features of 71 biopsy-proven LN patients were analyzed in a cross-sectional study during 2005–2011.

Results
Sixty-five women (91.5%) and six men (8.5%) were studied. The mean Activity Index (AI) and Chronicity Index (CI) were 6.2 ± 3.1 and 1.7 ± 1.5, respectively. The most common histopathologic presentation of kidneys was class IV (52.1%). Patients with more advanced International Society of Nephrology and the Renal Pathology Society (ISN/RPS) classes, had longer disease duration (P = 0.007), higher levels of blood urea nitrogen (P = 0.004) and serum creatinine (P = 0.035). The most frequent active lesion seen in renal biopsies was endocapillary hypercellularity (83.1%) while glomerular sclerosis was the most common chronic lesion (52.1%). Patients with chronic lesions, including glomerular sclerosis (P = 0.032), fibrous crescent (P = 0.001), interstitial fibrosis (P = 0.025) and tubular atrophy (P = 0.049) had higher serum creatinine levels. Hypertension was mainly seen in patients who had interstitial fibrosis and tubular atrophy (P = 0.026, 0.002 respectively). Moreover, subjects with renal failure had been more frequently involved with fibrinoid necrosis/karyorrhexis (P = 0.003), interstitial inflammation (P = 0.009), fibrous crescents (P = 0.041), tubular atrophy (P = 0.008) and interstitial fibrosis (P < 0.001).

Conclusion
We found that both histopathologic classification (ISN/RPS criteria) and histopathologic grading (US National Institutes of Health activity and chronicity indices) correlate to some clinical manifestations of LN. Considering these correlations may help to determine the patients' clinicopathologic status, prognosis and the need to immediate treatment. Nevertheless, it is necessary to clarify the accuracy of these findings in larger-scale prospective studies.

Analysis of clinicopathologic correlations in Iranian patients with lupus nephritis.

Purpose: Lupus nephritis is one of the most serious manifestations of Systemic lupus erythematosis and it is a major cause of morbidity and mortality. The aim of this study is to compare males and females in lupus nephritis presentations. 
Material and Methods: A cross-sectional study performed on forty five patients with biopsy proven Lupus Nephritis including 32 females and 13 males. All patients assessed by questionnaire form and investigated for hematological, biochemical, immunological, serological, urinalysis, and 24hrs urinary protein excretion.
Results: The current study shows female predominance 32(71.1%) compared with 13(28.9%) male. Class IV 15(33.3%) nephritis was the most common type followed by class III 9(20.9%).The male patients develop nephritis early in the course of Systemic lupus erythematosis than females, and they were more commonly had hypertension and edema, and the hematological, cardiovascular, pulmonary, and central nervous system were the most common extra renal manifestation in males while mucocutaneous manifestations were the commonest in females, and further more males had more proliferative type of Lupus nephritis than females. 
Conclusion: Males had more severe type of lupus nephritis than females.

The Clinicopathological Study of Lupus Nephritis

Amac:Lupus nefriti sistemik lupuseritematozusun en ciddi belirtilerinden biridir ve morbidite ve mortalitenin esas sebebidir. Bu calismanin amaci lupus nefriti olgularinda erkek ve kadinlar arasinda karsilastirma yapmaktir. Materyal ve Metod:Biyopsi ile Lupus nefriti oldugu kanitlanmis 45 hasta (32 kadin, 13 erkek) uzerinde kesitsel calisma uygulandi. Tum hastalara anket yapildi. Hastalara biyokimyasal, immunolojik, serolojik, hematolojik tetkikler ve idrar tahlili yapildi. 24 saatlik idrarda protein atilimina bakildi. Bulgular:Yapilan calismaya gore kadinlarin (32, %71.1) erkeklere (13, %28.9) nazaran daha baskin oldugu gorulmustur. En yaygin tip olarak 4. sinif nefriti (15, %33.3) sonrasinda ise 3. sinif nefriti (9, %20.9) gorulmustur.Sistemik lupuseritematozuslu erkek hastalar, kadinlardan daha erken bir donemde nefriti gelistirmislerdir.Erkeklerde daha yaygin hipertansiyon ve odem vardi.Kadinlarda bobrek disinda en yaygin belirti mukokutanoziken erkeklerdehematolojik, kardiyovaskuler, solunum ve merkezi sinir sistemi manifestasyonu gorulur.Kadinlara nazaran erkeklerde daha fazla proliferatif tipte lupus nefriti gozlenmistir. Sonuc:Erkeklerde kadinlara nazaran daha ciddi tipte lupus nefriti gorulmustur.

/pdf/lupus-nefritinin-klinikopatolojik-calismasi-47xic99tjw.pdf

Lupus Nefritinin Klinikopatolojik Çalışması

BACKGROUND: The influence of renal morphology and clinical factors at biopsy on the development of renal failure in patients with lupus nephritis remain controversial. We investigated the relation between renal histologic finding and clinical manifestations, and evaluated prognostic factors and short-term prognosis among patients with lupus nephritis. METHODS: Seventy patients with lupus nephritis were enrolled in the study from 1982 to 1992 at the Tri-Service General Hospital. Renal biopsy specimens from these patients were assessed according to the World Health Organization (WHO) classification, activity and chronicity indices, and clinical parameters. Survival was analyzed by using the day of renal biopsy as the starting point. The end point of renal survival was the date when patient started to receive regular hemodialysis. RESULTS: In pathological finding, one patient was grouped as Class I (1.4%); 14, as Class II (20%); 15, as Class III (21.4%); 29, as Class IV (41.4%); 9, as Class V (12.9%), and 2, as Class VI (2.9%). The scores of activity indices were highest in Class IV. The blood levels of C3 and C4 in Class V were significantly higher than Class IV. The values of BUN and 24-hour urine protein in Class II were significant lower than Class IV. Patients who progressed to renal failure had significantly higher numbers of death, higher serum creatinine and chronicity index, less creatinine clearance, and higher numbers of hypertension at the time of biopsy. Nephrotic syndrome was not associated with renal failure. Patient and renal survivals did not differ among WHO classifications. The patient and renal survivals were 84%, 60% and 85%, 72% at one and five years, respectively. Seventeen patients (24.2%) progressed to end-stage renal disease and 21 patients (30%) died during the study period. The leading causes of death were sepsis and renal failure. CONCLUSIONS: WHO classification had little correlation with clinical and renal information. At the time of biopsy the elevated serum creatinine and hypertension were good predictors for end-stage renal disease. Poor patient and renal survivals were found in this study.

Lupus nephritis: an analysis of 70 cases.

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Lupus nephritis: an analysis of 70 cases.