Renal Biopsy in Rheumatoid Arthritis

Abstract

A total of 32 percutaneous renal biopsies were examined from patients with rheumatoid arthritis. The renal biopsies in these patients present a very heterogeneous picture; there were 9 cases of chronic interstitial nephritis and 4 cases of amyloidosis. In one patient whose renal biopsy showed glomerulitis, a muscle biopsy resulted in a diagnosis of polyarteritis nodosa. 11 biopsies showed a normal histology, and 6 showed arteriosclerosis of the small arteries. Finally, 1 patient showed so-called membranous glomerulonephritis; this may have been the coincidental presence of 2 diseases. We were unable to confirm the existence of a vascular rheumatoid lesion, as previously reported in the litterature. Employing a technique which permitted a quantitative evaluation of the nuclear distribution in the glomeruli, this distribution was examined in the biopsies from 28 patients with rheumatoid arthritis and in 11 patients with gallstones, but with normal renal function and normal blood pressure. The presence of a glomerular hypercellularity in rheumatoid arthritis, as has previously been claimed was not confirmed. It was likewise not possible to demonstrate local hypercellularity in the glomeruli of patients with rheumatoid arthritis and normal renal biopsies.

Renal Biopsy: Current Views and Controversies

“…Detailed reviews, photographs and references may be found in the presentations of Zollinger and Mihatsch [201], Churg and Gerber [8], Johannesson [202], Mandal [203], Jenis andLowenthal [204] and Brun and Olsen [205].…”

Renal Pathology in Patients with Rheumatoid Arthritis

“…Brim et al [9] in 1965 examined renal biopsies from 31 patients with rheumatoid arthritis and found a variety of lesions -9 instances of chronic interstitial nephritis, 6 of arteriosclerosis of the small arte ries. 4 of amyloidosis, and 1 of membranous nephropathyin addition to 11 patients with normal histology.…”

Persistent High Prevalence of Thyroid Antibodies after Immunosuppressive Therapy in Subjects with Glomerulonephritis

“…Percutaneous renal biopsy specimens were prepared for light microscopy, direct immunofluorescence microscopy and, in some cases, electron microscopy, essentially as described by Brun and Olsen [19]. The specimens were evaluated by Dr. H. Henriksson and Dr. P. Alm at the Department of Pathology, Lund.…”