Lupus nephritis

Baldwin, David S.; Gluck, Melvin C.; Jerome, Lowenstein; Gallo, Gloria

doi:10.1016/0002-9343(77)90345-x

Cited by 271 publications

(17 citation statements)

References 27 publications

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“…The result seems different from several previous studies, which all reported a predominance of transitions between classes III and IV, with or without an additional class V, disease, with an incidence varying from 36 to 54% [10,11,21]. Some other studies also showed the high frequency of transitions from class III or IV to class II disease [8,9,19,20,22], which was not observed in our study. It is, however, important to note that under the current ISN/RPS definition, class III and IV diseases are both proliferative nephritis, and differ only by the percentage of glomerular involvement.…”

Section: Discussioncontrasting

confidence: 99%

Repeat Renal Biopsy in Lupus Nephritis: A Change in Histological Pattern Is Common

et al. 2011

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Background: The role of longitudinal change in sequential renal biopsies of lupus nephritis (LN) patient remains elusive. Methods: Clinical and pathological documents of 156 LN patients with repeat renal biopsies (412 times) were collected from a database. Results: The percent of transformation of the biopsy class from reference biopsies to repeat biopsies was 75%. For the reference biopsies that showed pure proliferative, pure membranous, and mixed nephritis, the histological pattern in the repeat biopsies changed in 57.8, 50.0, and 60.4%, respectively. As compared to reference biopsy, repeat biopsy had a higher degree of tubulointerstitial scarring (p < 0.001), chronicity index (p < 0.001) and serum creatinine (p < 0.001). In addition, baseline serum creatinine was significantly lower (p = 0.004), and the time lapse between the two biopsies was significantly longer (p < 0.001) amongst patients who had a change in the histological pattern upon repeat renal biopsy than those whose histological pattern remained the same. Conclusion: The present study suggests that a change in the histological class of LN is common in systemic lupus erythematosus patients with lupus flare, and the histology during disease flare could not be predicted by baseline clinical, biochemical, or pathological parameters. Our results indicate that when there is lupus flare with renal involvement, repeat renal biopsy is often necessary to guide the treatment.

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Section: Discussioncontrasting

confidence: 99%

Repeat Renal Biopsy in Lupus Nephritis: A Change in Histological Pattern Is Common

et al. 2011

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“…Abnormal histology was found in 3 patients with normal urinalysis and renal function but who had hypocomplementaemia. This has been found previously (Baldwin and Gallo, 1975;Lee et al, 1977).…”

Section: Musculoskeletal Manifestationssupporting

confidence: 87%

Systemic lupus erythematosus. A prospective analysis.

Grigor¹,

Edmonds²,

Lewkonia³

et al. 1978

Annals of the Rheumatic Diseases

228

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SUMMARY The spectrum of organ involvement in 50 patients with systemic lupus erythematosus has been assessed in a prospective study. All patients were admitted to hospital electively for 2 days and a complete clinical and laboratory assessment protocol completed. Subsequent hospital admissions depended on clinical status. The overall mean observation period was 29 months. Widespread multisystem involvement was found in every patient. Subclinical abnormalities of respiratory and cerebral function were common even in patients in clinical remission. A more conservative approach than has been generally recomnmended was used for the management of systemic lupus erythematosus and is supported by the estimated 5-year survival of 98 %.

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“…Clinically, renal biopsy is usually performed for the diagnosis and therapeutic guidance for lupus nephritis (LN). Results from renal biopsies have indicated that LN often presents with transition from one histologic class to another at successive follow-ups [1, 2, 9, 10, 11]. Consequently, serial renal biopsies are necessary to evaluate the accurate activity of LN.…”

Section: Introductionmentioning

confidence: 99%

Increased Excretions of β<sub>2</sub>-Microglobulin, IL-6, and IL-8 and Decreased Excretion of Tamm-Horsfall Glycoprotein in Urine of Patients with Active Lupus nephritis

Tsai

et al. 2000

Nephron

145

102

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Tubulointerstitial nephritis is a less frequently recognized but important complication of systemic lupus erythematosus. We have investigated the cytokine β₂-microglobulin (β₂M) and Tamm-Horsfall glycoprotein (THG) excretions in the urine of systemic lupus erythematosus patients to identify indices for evaluation of tubulointerstitial inflammation in lupus nephritis (LN). Daily urine was collected from 15 patients with active LN, from 12 patients with inactive LN, and from 17 normal subjects. The amounts of soluble interleukin (IL) 2 receptor, IL-6, IL-8, β₂M, and THG in urine were measured. β₂M and THG were regarded as indicators of proximal and distal renal tubule function, respectively. The urinary excretions of IL-6 and IL-8 were significantly higher in patients with active LN than in those with inactive LN and in normal individuals. The excretion of soluble IL-2 receptor in all three groups of subjects was not significantly different. On the other hand, the excretion of β₂M in patients with LN was significantly higher than that in normal individuals. The excretion of β₂M in patients with active or inactive LN was not significantly different. The THG excretion was lower in patients with active LN and tubulointerstitial inflammation as compared with patients with inactive LN or normal individuals. Six patients underwent pulse cyclophosphamide therapy during the course of experiments. Five of them showed a decrease in IL-8 and IL-6 excretions in urine after the treatment. The excretions of β₂M and THG in urine, in addition to IL-6 and IL-8, can reflect the renal inflammatory activity in patients with lupus tubulointerstitial nephritis as well as in those having lupus glomerulonephritis.

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Lupus nephritis

Cited by 271 publications

References 27 publications

Repeat Renal Biopsy in Lupus Nephritis: A Change in Histological Pattern Is Common

Repeat Renal Biopsy in Lupus Nephritis: A Change in Histological Pattern Is Common

Systemic lupus erythematosus. A prospective analysis.

Increased Excretions of β<sub>2</sub>-Microglobulin, IL-6, and IL-8 and Decreased Excretion of Tamm-Horsfall Glycoprotein in Urine of Patients with Active Lupus nephritis

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