Renal involvement in antiphospholipid syndrome

Vlachoyiannopoulos, Panayiotis G.; Kanellopoulos, Panagiotis Georgios; Tektonidou, Maria G; Moutsopoulos, Haralampos Μ.

doi:10.1093/ndt/16.suppl_6.60

Cited by 17 publications

(10 citation statements)

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“…APS nephropathy-compatible features, in the absence of other characteristics of lupus nephritis, occurred in only one biopsy from patients with PAPS. On the contrary, the other four kidney biopsies showed immune complex glomerulonephritis, with features of MN in two (29). Our findings are, in some way, in agreement with this study and with a previous one on 29 kidney biopsies from patients with PAPS that reported a high frequency of glomerulonephritis (almost one third) and especially MN (19).…”

Section: Discussionsupporting

confidence: 93%

“…In a large series of patients with APS, renal complications occurred in 2.7% of cases (5); however, this prevalence is probably underestimated, because only thrombotic lesions were considered and patients with APS rarely undergo a kidney biopsy because of the frequent presence of thrombocytopenia and/or anticoagulant treatment. Another group found, in a series of 78 patients with PAPS, signs of renal involvement in eight (10%) (29). APS nephropathy-compatible features, in the absence of other characteristics of lupus nephritis, occurred in only one biopsy from patients with PAPS.…”

Section: Discussionmentioning

confidence: 94%

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Renal Involvement in Primary Antiphospholipid Syndrome

Sinico¹,

Cavazzana²,

Nuzzo³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 94%

Renal Involvement in Primary Antiphospholipid Syndrome

Sinico¹,

Cavazzana²,

Nuzzo³

et al. 2010

Clinical Journal of the American Society of Nephrology

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“…174−181 Our group has recently found that patients with APS nephropathy develop hypertension, raised serum creatinine levels, characteristic renal biopsy findings, and progression of histological lesions, factors that are associated with a poor renal outcome. 182,183 The definition of the so-called aPL-associated nephropathy includes the co-existence of aPL along with histopathological detection of one or more of the following: a) thrombotic microangiopathy involving both arterioles and glomerular capillaries, b) fibrous intimal hyperplasia, c) fibrous and/or fibrocellular occlusions, d) focal cortical atrophy, or e) tubular thyroidization. Vasculitis, thrombotic thrombocytopenic purpura, and other reasons for chronic renal ischemia shoud be excluded.…”

Section: Clinical Manifestations Of the Antiphospholipid Syndromementioning

confidence: 99%

Antiphospholipid Antibodies: Laboratory and Pathogenetic Aspects

Vlachoyiannopoulos

Samarkos

Sikara

et al. 2007

Critical Reviews in Clinical Laboratory Sciences

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Antiphospholipid antibodies (aPL) constitute a heterogeneous group of autoantibodies that share the ability to bind phospholipids (PL) alone, protein-PL complexes, or PL-binding proteins. They have been detected in isolation, in association with autoimmune diseases such as systemic lupus erythematosus (SLE), and during the course of different infections. aPL have been associated with an array of clinical manifestations in virtually every organ, although deep vein and arterial thrombosis as well as pregnancy morbidity are predominant. The co-occurrence of these clinical findings with aPL constitutes the so-called antiphospholipid syndrome (APS). aPL can be detected by immunological methods [e.g., anticardiolipin antibodies (aCL)] or by functional methods that exploit the effect of aPL on blood coagulation [lupus anticoagulant (LA)]. Since aPL are heterogeneous, numerous immunological and coagulation assays have been developed. These assays have not been fully standardized, and, therefore, problems such as high interlaboratory variation are relatively frequent. Recently, recommendations have been published regarding LA and aCL testing. Not all aPL are pathogenic. However, when they are not associated with infections, they have a role in the pathogenesis of APS. Clinical and experimental data have shown that aPL exert their pathogenic activity by interfering with the function of coagulation factors, such as thrombin and factors X, XI and XII, and with the function of anticoagulant proteins of the protein C system. In addition, aPL interaction with platelets and endothelial cells induces a pro-adhesive activated phenotype.

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“…16 In a recent study of Vlachoyiannopoulos et al, renal disease was studied in a cohort of 248 patients with APS and SLE with a positive titre of anticardiolipin antibodies, among which 40% had evidence of renal disease. 17 A renal biopsy was performed in 79% of the patients for diagnostic purposes. A high percentage of patients with APS had hypertension (59%) compared with those without the syndrome, while increased levels of creatinine, proteinuria, and haematuria, with or without the presence of casts, were similar in both groups studied.…”

Section: Newly Recognised Types Of Renal Disease In Slementioning

confidence: 99%