Outcome of silent lupus nephritis

Gonzalez-Crespo, Maria R.; López, José I.; Usera, Gabriel; Poveda, María Antonia Martorell; Gómez-Reino, Juan J.

doi:10.1016/s0049-0172(96)80027-8

Cited by 60 publications

(38 citation statements)

References 47 publications

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“…The renal survival rate of silent LN at 51 months is 98%, in contrast with the 60% to 86% 5-year renal survival rate observed in patients with clinical lupus nephritis (11). Although the preferred treatment for silent LN has not been clarified, in view of the superior outcomes, aggressive treatment is required only when clinical renal abnormalities manifest (11). In addition, serological abnormalities can be negative in patients with early lupus nephritis, especially in those with membranous lupus nephritis (13).…”

Section: Discussionmentioning

confidence: 72%

“…Wada et al reported that, in their study, 25.8% of the patients with silent LN developed overt LN within a follow-up period of at least 60 months (12). The renal survival rate of silent LN at 51 months is 98%, in contrast with the 60% to 86% 5-year renal survival rate observed in patients with clinical lupus nephritis (11). Although the preferred treatment for silent LN has not been clarified, in view of the superior outcomes, aggressive treatment is required only when clinical renal abnormalities manifest (11).…”

Section: Discussionmentioning

confidence: 87%

“…Histological changes on renal biopsies are detected in almost all patients with systemic lupus erythematosus (SLE), even in cases involving no clinical evidence of renal disease (8,9), and the term 'silent lupus nephritis (LN)' is generally recognized to reflect a histopathological diagnosis of LN without clinical renal abnormalities (10,11). The prevalence of silent LN type V is relatively low.…”

Section: Discussionmentioning

confidence: 99%

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Membranous Nephropathy that First Presented in Pregnancy

et al. 2013

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A 37-year-old woman at 17 weeks of gestation who was first noted to have proteinuria and microscopic hematuria at 13 weeks of gestation was admitted to our hospital with proteinuria that progressed to nephrotic syndrome (NS). Despite the treatment with prednisolone, including methylprednisolone pulse therapy, the NS worsened. The patient underwent an elective abortion at 21 weeks of gestation, and the NS then went into partial remission. A renal biopsy revealed membranous nephropathy (MN). There was no evidence of secondary MN. This is the first reported case of subclinical idiopathic MN that first developed in pregnancy.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Membranous Nephropathy that First Presented in Pregnancy

et al. 2013

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“…Külön kiemelendő az úgynevezett "silent" vagy "csendes" lupus nephritis, amikor a teljesen tünetmentes betegen elvégzett biopszia nephritist igazol [12]. Egy vizsgá-latban SLE-s betegeknek ajánlották fel a biopsziás mintavétel lehetőségét, 55%-uknak nem volt klinikailag vesebetegségre utaló tünete, ennek ellenére a klinikailag tünetmentes betegek 15%-ánál III-as vagy IV-es, további 10%-uknál V-ös stádiumú lupus nephritist diagnosztizál-tak [13].…”

Section: A Lupus Nephritis Osztályozása Lefolyása Prognózisaunclassified

A lupus nephritis kezelésének irányelvei, valamint a mycofenolat mofetil hatékonyságának bemutatása intézetünk lupus nephritises betegeinek körében

Szabó

Kiss

2016

Orvosi Hetilap

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A lupus nephritis kezelésének irányelvei, valamint a mycofenolat mofetil hatékonyságának bemutatása intézetünk lupus nephritises betegeinek körébenSzabó Melinda Zsuzsanna dr. ■ Kiss Emese dr. Országos Reumatológiai és Fizioterápiás Intézet, BudapestA szerzők közleményükben a lupus nephritis kezelésének legújabb irányelvei mellett bemutatják saját mycofenolat mofetillel szerzett tapasztalataikat a betegség kezelésében. A lupus nephritis és főleg a proliferatív formája olyan gyakori és komoly manifesztációja a szisztémás lupus erythematosusnak, amely végstádiumú veseelégtelenséghez vagy akár halálhoz is vezethet. Az elmúlt évtizedekben a lupus nephritis kezelése sokat fejlődött, ma már a kedvezőbb mellékhatás-profilú mycofenolat mofetil a cyclophosphamid alternatívájává vált a III-as és IV-es osztályú glomerulonephritis indukciós és fenntartó kezelésében. Lupus nephritis diagnózissal eddig 25 betegüknek kértek egyedi méltányosság alapján támogatást mycofenolat mofetil adására. Szövettanilag legtöbben a WHO III (A/C) és IV (A) szövettani osztályába tartoztak (30-30%), beszűkült vesefunkció csak 16%-ukban volt jelen. Glükokortikoid és cyclophosphamid indukciós kezelés után adott mycofenolatterápia mellett az átlagos napi proteinuria 3,18 g/napról 1,06 g/napra csökkent. A betegek 24%-ánál jött létre komplett, 48%-ánál részleges remisszió. Ezek alapján a mycofenolat mofetil hatékony kezelésnek tartható a proliferatív lupus nephritis kezelésében. Orv. Hetil., 2016, 157(35), 1385-1393.Kulcsszavak: lupus nephritis, szisztémás lupus erythematosus, mycofenolat mofetil, cyclophosphamid, rituximab Clinical guideline for the treatment of lupus nephritis and single-centre results of mycofenolate mofetil among patients with lupus nephritis in the National Institute of Rheumatology and Physiotherapy, BudapestThe authors present the latest guideline for the treatment of lupus nephritis and their own single-centre results with mycofenolate mofetil treated lupus nephritis. Lupus nephritis and mainly its proliferative form is a frequent and potentially life-threatening manifestation of systemic lupus erythematosus that can lead to end-stage renal disease. The treatment of lupus nephritis greatly improved in the last decades; mycofenolate mofetil has become an alternative of cyclophosphamide both in remission induction and as a maintenance regimen as well in the treatment of Class III and IV glomerulonephritis. The authors ordered mycofenolate mofetil for 25 patients with lupus nephritis so far. Histologically most of them had Class III (A/C) or IV (A) glomerulonephritis (30-30%), and only 16% of the patients had renal impairment at that time. Mycofenolate mofetil given after glucocorticoid and cyclophosphamide induction therapy reduced the daily proteinuria from 3.18 grs to 1.06 grs. Complete remission could be achieved in 24% and partial remission in 48% of the patients. The authors conclude that mycofenolate mofetil is effective in the therapy of lupus nephritis.

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“…Silent LN has been reported not only in class II but also in class IV (62)(63)(64)(65)(66)(67)(68). Even patients with low-level proteinuria (,1 g/24 h) have demonstrated significant renal involvement with proliferative LN (classes III or IV) (69,70).…”

Section: Clinicopathologic Correlationsmentioning

confidence: 99%

Lupus Nephritis

Giannico

Fogo

2013

Clinical Journal of the American Society of Nephrology

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SummaryMost patients with SLE develop kidney disease related to this systemic underlying disease process. Lupus nephritis is an important cause of morbidity and even mortality in patients with systemic lupus erythematosus. Lupus nephritis has diverse morphologic manifestations with varying clinical presentations and consequences. The pathogeneses involve immune complexes, which can deposit anywhere in the kidney, and other mechanisms, including endothelial injury, podocytopathy, and tubulointerstitial injury. Treatment and prognosis accordingly range from excellent even with only observation with minimal mesangial deposits, to kidney failure despite aggressive immunosuppression in patients with severe proliferative disease. Renal biopsy plays a crucial role in the diagnosis of the specific form of lupus nephritis in any patient. However, the role of the renal biopsy in prediction of outcome, treatment, and prognosis has been controversial. We will review the current classification of lupus nephritis and the value of renal biopsy in the management of these patients.

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Outcome of silent lupus nephritis

Cited by 60 publications

References 47 publications

Membranous Nephropathy that First Presented in Pregnancy

Membranous Nephropathy that First Presented in Pregnancy

A lupus nephritis kezelésének irányelvei, valamint a mycofenolat mofetil hatékonyságának bemutatása intézetünk lupus nephritises betegeinek körében

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