Mesangial lupus nephritis with associated nephrotic syndrome.

1997 ◽  
Vol 8 (7) ◽  
pp. 1199-1204
Author(s):  
N Stankeviciute ◽  
W Jao ◽  
A Bakir ◽  
J P Lash
Keyword(s):  
Nephrotic Syndrome ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
World Health ◽  
Clinical Tool ◽  
Laboratory Findings ◽  
Glomerular Lesion ◽  
Health Organization ◽  
Lupus Glomerulonephritis ◽  
Nephrotic Range Proteinuria

Patients with mesangial proliferative lupus glomerulonephritis (World Health Organization class II) are generally believed to have only mild to moderate proteinuria and normal renal function. However, there have been several reports of patients with mesangial lupus with nephrotic-range proteinuria. In this report, we present two additional cases and review the literature. Of seven reported cases, persistent nephrotic syndrome was observed in four, morphologic transformation occurred in three, and all but one presented with varying degrees of azotemia. These cases reinforce the concept that in systemic lupus erythematosus, laboratory findings may not correlate well with the underlying glomerular lesion, and therefore, the renal biopsy is an essential clinical tool in the approach to lupus nephritis.

Development of lupus nephritis in a patient with previous scleroderma renal crisis

Lupus ◽  
2018 ◽  
Vol 27 (10) ◽  
pp. 1732-1734 ◽  
Author(s):  
E McConville ◽  
D Smith ◽  
E Bélanger ◽  
C Ivory
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Overlap Syndrome ◽  
Scleroderma Renal Crisis ◽  
Undifferentiated Connective Tissue Disease ◽  
Laboratory Findings ◽  
Repeat Renal Biopsy ◽  
Nephrotic Range Proteinuria ◽  
Renal Crisis ◽  
Made In

We present a case of scleroderma overlap syndrome with systemic lupus erythematosus (SLE) including complications of both scleroderma renal crisis and lupus nephritis. Our patient was initially diagnosed with undifferentiated connective tissue disease in 1996. A diagnosis of scleroderma was made in 2010 after she developed scleroderma renal crisis. She remained stable until 2016, when she presented with Salmonella bacteremia, renal failure, nephrotic range proteinuria and microscopic hematuria. Laboratory findings were consistent lupus with positive ds-DNA, hypocomplementemia and repeat renal biopsy showed lupus nephritis.

scholarly journals P087 Mortality trends from systemic lupus erythematosus in Cuba: 2001-2014

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Halbert Hernández Negrín
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Health Problem ◽  
Time Trends ◽  
Reference Population ◽  
World Health ◽  
Mortality Data ◽  
Systemic Lupus ◽  
Mortality Trends ◽  
Health Organization

Abstract Background/Aims  There is little research on the mortality of Cuban patients with systemic lupus erythematosus (SLE), with not enough impact to recognize SLE as a health problem in the country. Our aim was to identify time trends and geographic variability in the mortality of Cuban patients with SLE. Methods  Mortality data of decedents over 15 years old were retrieved from the Cuban Ministry of Public Health mortality database, based on International Classification of Disease (ICD), Tenth Revision (ICD-10, code M32). We computed age-standardized mortality rate (ASMR) for each year and province as the estimated number of deaths per million inhabitants and its 95% confidence interval (95% CI) using World Health Organization reference population. The 2001-2014 time trends were analyzed using Jointpoint software. Results  Between 2001 and 2014, 1,054 deaths from SLE were found, mostly women (89.0%), white (54.4%) with a median age of 43 years (interquartile range: 34-53). In 2014 the ASMR caused by SLE per million inhabitants was 14.4 (95% CI: 10.9 to 18.4) in women and 1.3 (95% CI: 0.5 to 3.2) in men. A growing time trend was identified in the ASMR by SLE throughout the period (average annual percentage change [AAPC]: 1.6; 95% CI: 0.6 to 2.6), highest in males (AAPC: 5.6; 95% CI: 1.7 to 9.7) than in females (AAPC: 1.2; 95% CI: 0.3 to 2.0). The highest mortality in women was concentrated in the provinces of Camagüey, Las Tunas and Granma, and in the case of men, in Havana and Ciego de Ávila. Conclusion  The variation in the magnitude of the risk of dying from SLE over time and geographic areas indicates the possible influence of biological, environmental, socioeconomic and health systems factors. The growing trend in SLE mortality in Cuba demands its recognition as an important health problem and immediate actions that help mitigate it. Disclosure  H. Hernández Negrín: None.

scholarly journals AB0421 EFFECT OF BODY WEIGHT ON COMPLEMENT LEVELS IN SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1510.3-1510
Author(s):  
L. Kondrateva ◽  
T. Popkova ◽  
E. Nasonov ◽  
A. Lila
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Normal Weight ◽  
World Health ◽  
Systemic Lupus ◽  
Obesity Status ◽  
Health Organization ◽  
The Complement System

Background:The complement system is a recognized biomarker for diagnosis or monitoring of disease activity in systemic lupus erythematosus (SLE) patients (pts). But on the other hand, it has been linked to insulin resistance and obesity in general population.Objectives:To find out whether overweight/obesity can modify C3 or C4 levels in SLE pts.Methods:A total of 92 SLE pts (83 women, 9 men, 39 [34;47] years old) were enrolled in the study. Median disease duration was 6[2;14] years, and SLE activity using SLEDAI-2K was 4[2;8]. SLE pts were treated with glucocorticoids (89%), hydroxychloroquine (78%), immunosuppressants (28%), biologics (10%). The overweight/obesity status was determined by World Health Organization criteria in patients with body mass index (BMI) ≥25kg/m2.Results:Overweight/obesity were established in 46% SLE pts. Overweight/obese SLE pts were older than pts with normal BMI (40[36;48] vs 37[31;44] years, р=0,02), and had lower SLEDAI-2K (3[2;6] vs 6[4;8], p<0,01). Lower C3 concentrations were found in 36% overweight/obese pts vs 68% pts with normal weight (р<0,01), decreased C4 levels - in 19% vs 30% pts (p=0,33), median C3 concentrations were 0,98[0,81;1,14] g/l vs 0,84[0,69;0;96] g/l (р<0,01), and C4 levels were 0,15[0,10;0,19] g/l vs 0,12[0,09;0,16] g/l, respectively (p=0,03). C3 and C4 levels negatively correlated with SLEDAI-2K (r=-0,5, p<0,01 for both), the effect was more strongly pronounced in patients with BMI≥25kg/m2 (r=-0,6, p<0,01 for both) than in those with normal weight (r=-0,2, p=0,09 for C3, r=-0,3, p=0,04 for C4).Conclusion:Overweight/obesity status in SLE pts was associated with increased levels of complement proteins, therefore decreased C3 or C4 levels in patients with BMI≥25kg/m2 are more likely related to disease activity and, can potentially induce SLE flares.Disclosure of Interests: :None declared

scholarly journals A patient with systemic lupus erythematosus and lupus nephritis: A 12-year follow-up

2011 ◽  
Vol 68 (8) ◽  
pp. 705-708
Author(s):  
Natasa Jovanovic ◽  
Jasmina Markovic-Lipkovski ◽  
Stevan Pavlovic ◽  
Biljana Stojimirovic
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Nephrotic Syndrome ◽  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Immunosuppressive Drugs ◽  
Systemic Lupus ◽  
Younger Women ◽  
The Right

Introduction. Systemic lupus erythematosus (SLE) is a chronic immunological disease causing a significant morbidity and mortality in younger women and involving several organs and systems, most often the kidneys, being consequently the incidence of lupus nephritis (LN) about 60%. Case report. We reported a 57 year-old patient with the diagnosed SLE in 1995. Pathohistological analysis of kidney biopsy revealed LN type V. The patient was treated with corticosteroid pulses and azathioprine during one year. A remission was achieved and maintained with prednisone, 15 mg daily. Nephrotic relapse was diagnosed in 2006 and the second kidney biopsy revealed recent kidney infarction due to extensive vasculitis. Soon, a cerebrovascul insult developed and CT-scan revealed endocranial infarctus. The patient was treated with corticosteroids and cyclophosphamide pulses (totally VI monthly pulses), and also with low-molecular heparine, anticoagulants and salicylates because of the right leg phlebothrombosis. After the pulses, the patient was adviced to take prednisone 20 mg daily and azothioprine 100 mg daily, and 6 months later mycophenolate mofetil because of persistent active serological immunological findings (ANA 1 : 320) and nephrotic syndrome. Mycophenolate mofetil was efficient in inducing and maintaining remission of nephrotic syndrome. Conclusion. The aim of LN treatment is to achieve and maintain remission, improve patients? outcome, reduce the toxicity of immunosuppressive drugs and the incidence of relapses. Mycophenolate mofetil was shown to be efficient in inducing and maintaining remission of nephrotic syndrome in the frame of LN.

scholarly journals Hydroxychloroquine and chloroquine retinal safety concerns during COVID-19 outbreak

2020 ◽  
Author(s):  
Massimo Nicolò ◽  
Lorenzo Ferro Desideri ◽  
Matteo Bassetti ◽  
Carlo Enrico Traverso
Keyword(s):  
Lupus Erythematosus ◽  
Safety Concern ◽  
Retinal Toxicity ◽  
World Health ◽  
Cochrane Library ◽  
Safety Concerns ◽  
Search Terms ◽  
Global Pandemic ◽  
Screening Strategies ◽  
Health Organization

Abstract Purpose The current coronavirus disease 2019 (COVID-19) has been declared by the World Health Organization a global pandemic. Chloroquine (CQ) and hydroxychloroquine (HCQ) have been largely adopted in the clinical setting for the management of SARS-CoV-2 infection; however, their known retinal toxicity has raised some safety concerns, especially considering the higher-dosage employed for COVID-19 patients as compared with their suggested posology for their usual indications, including systemic lupus erythematosus and other rheumatic diseases. In this review, we will discuss the optimal dosages recommended for COVID-19 patients when treated with HCQ and CQ. Methods A comprehensive literature search was performed in PubMed, Cochrane library, Embase and Scopus, by using the following search terms: "chloroquine retinal toxicity" and "hydroxychloroquine retinal toxicity" alone or in combination with "coronavirus", "COVID-19", " SARS-CoV-2 infection " from inception to August 2020. Results Although there is still no consistent evidence about HCQ/CQ retinal toxicity in patients with COVID-19, these possible drug-related retinal adverse events may represent a major safety concern. For this reason, appropriate screening strategies, including telemedicine, should be developed in the near future. Conclusion A possible future clinical perspective for patients with COVID-19 treated with HCQ/CQ could reside in the multidisciplinary collaboration between ophthalmologists monitoring the risk of HCQ/CQ-related retinal toxicity and those physicians treating COVID-19 infection.

Significance of Abuse Chemical Contamination of Returnable Dairy Containers: Hazard Assessment

1978 ◽  
Vol 41 (12) ◽  
pp. 965-973 ◽  
Author(s):  
JOHN M. GASAWAY
Keyword(s):  
Hazard Assessment ◽  
Pesticide Residues ◽  
Daily Intake ◽  
World Health ◽  
Test Results ◽  
Chemical Contamination ◽  
Laboratory Findings ◽  
Laboratory Test Results ◽  
Health Organization ◽  
Water Contents

Certain pesticide residues reabsorbed into milk (or water) contents when stored in LEXAN® resin and polyethylene plastic returnable milk containers that had been exposed to diluted pesticide products, washed, and subsequently filled. The significance of these laboratory test results is comprehensively discussed by attempting to characterize the nature of exposure to pesticide residues from a washed returnable dairy container, as opposed to exposure to milk containing pesticide residues of non-container origin. Laboratory findings are compared to actual public use experience with returnable plastic dairy containers. A hazard assessment is presented, which includes a comparison of quantities of pesticide residues found extracting with existing Federal milk tolerance standards, food tolerance standards, unavoidable contaminant food additive regulations, World Health Organization and Safe Drinking Water Committee acceptable daily intake values. The probability of purchase of milk that is contaminated with pesticide residues, where the washed returnable dairy container is the source, is presented.

scholarly journals Podocyte Injury in Lupus Nephritis

2019 ◽  
Vol 8 (9) ◽  
pp. 1340 ◽  
Author(s):  
Hamza Sakhi ◽  
Anissa Moktefi ◽  
Khedidja Bouachi ◽  
Vincent Audard ◽  
Carole Hénique ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Glomerular Injury ◽  
Crescent Formation ◽  
Podocyte Injury ◽  
Inflammatory Processes ◽  
Lupus Podocytopathy ◽  
Parietal Epithelial Cells ◽  
Lupus Glomerulonephritis

Systemic lupus erythematosus (SLE) is characterized by a broad spectrum of renal lesions. In lupus glomerulonephritis, histological classifications are based on immune-complex (IC) deposits and hypercellularity lesions (mesangial and/or endocapillary) in the glomeruli. However, there is compelling evidence to suggest that glomerular epithelial cells, and podocytes in particular, are also involved in glomerular injury in patients with SLE. Podocytes now appear to be not only subject to collateral damage due to glomerular capillary lesions secondary to IC and inflammatory processes, but they are also a potential direct target in lupus nephritis. Improvements in our understanding of podocyte injury could improve the classification of lupus glomerulonephritis. Indeed, podocyte injury may be prominent in two major presentations: lupus podocytopathy and glomerular crescent formation, in which glomerular parietal epithelial cells play also a key role. We review here the contribution of podocyte impairment to different presentations of lupus nephritis, focusing on the podocyte signaling pathways involved in these lesions.

scholarly journals A clinico-pathological study of lupus nephritis based on the International Society of Nephrology-Renal Pathology Society 2003 classification system

2017 ◽  
Vol 9 (03) ◽  
pp. 149-155
Author(s):  
Suchitha Satish ◽  
Pallavi Deka ◽  
Manjunath Sanjeev Shetty
Keyword(s):  
Lupus Nephritis ◽  
Renal Biopsy ◽  
International Society ◽  
Lupus Erythematosus ◽  
Classification System ◽  
Renal Involvement ◽  
Response To Therapy ◽  
Renal Pathology ◽  
Laboratory Findings ◽  
Presenting Symptoms

Abstract INTRODUCTION: Lupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). Renal involvement is a major determinant of the prognosis of SLE. The histological classification of LN is a key factor in determining the renal survival of patients with LN. Prompt recognition and treatment of renal disease are important, as early response to therapy is correlated with better outcome and renal biopsy plays an important role in achieving this. OBJECTIVES: The objective of this study was to correlate the clinical and laboratory findings with histopathological classes of LN as per the 2003 International Society of Nephrology-Renal Pathology Society (ISN/RPS) classification system. PATIENTS AND METHODS: Fifty-six patients with SLE, undergoing a renal biopsy for renal dysfunction were studied. The comparison of data from multiple groups was made by Pearson’s Chi-square test and between two groups by independent samples t-test. The values of P < 0.05 were considered statistically significant. RESULTS: Of the 56 cases studied, 51 (91.1%) were females. The most common presenting symptoms were edema, arthralgia, and hypertension. Class IV (55.4%) was the most common class. Thirty-nine (69.6%) cases showed full house immunostaining. Hypertension, hematuria, proteinuria, and tu bulo-interstitial disease showed a significant correlation (P < 0.05) with ISN/RPS classification, 2003. CONCLUSION: Assessment and management of patients with suspected LN are greatly facilitated through information obtained by renal biopsy. Since renal morphology may predict long-term prognosis, and no clinical or laboratory feature uniformly predicts prognosis, it is important to study the constellation of features in LN for better patient management.

scholarly journals Discoid lupus erythematosus with epithelial dysplasia: a case report

2017 ◽  
Vol 5 (6) ◽  
pp. 2833
Author(s):  
Harishchandra Rai ◽  
Anitha Dayakar ◽  
Supriya H. ◽  
Elizabeth Sojan
Keyword(s):  
Lupus Erythematosus ◽  
World Literature ◽  
Rare Case ◽  
Connective Tissue Diseases ◽  
Epithelial Dysplasia ◽  
World Health ◽  
Discoid Lupus Erythematosus ◽  
The World ◽  
Malignant Changes ◽  
Health Organization

Lupus erythematosus is a classic example of an immunologically mediated condition and is one of the most common of the so called “collagen vascular” or connective tissue diseases. Lupus erythematosus was first described by Biett in 1828 and Kaposi in 1872. Development of squamous cell carcinoma (SCC) can occur in DLE, with about 20 cases reported in the world literature to-date, which led the World Health Organization (WHO) to classify DLE as one of the precancerous conditions. Thus malignant changes in such a condition must be given utmost importance. This article focuses on a rare case of DLE with epithelial dysplasia.

scholarly journals What is New in COVID-19 and What We Need to Do Against This Pandemic Infection? A Comparative Review

2020 ◽  
Vol 8 (2) ◽  
pp. 116-125
Author(s):  
Sadaf Naeem ◽  
Yousra Shafiq ◽  
Muhammad Arif Asghar
Keyword(s):  
Preventive Measures ◽  
World Health ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Comparative Review ◽  
Lactate Dehydrogenase C ◽  
The Many ◽  
The One ◽  
Health Organization ◽  
Corona Viruses

Background: Initially, large number of COVID-19 cases reported from Wuhan City, China, reflected that this is likely the zoonotic origin of COVID-19. In March, 2020; it has since been declared a serious pandemic infection by the World Health Organization (WHO).  Objective: The main objective of this review was to addressed what gaps still exist. Many researchers have reported the many common characteristics of COVID-19 virus in comparison with other pandemic viruses, while the major differences are discussed in this review. Method: In this review, we investigated the general characteristics of COVID-19 its diagnosis and other preventive measures in comparison with other pandemic viruses that we know or we need to know. Results: All reported corona viruses belong to the one genus and family Coronavirus and Coronaviridae. The COVID-19 virus spreads easily and exponentially multiple times compares to other viruses. It can be divided into four antigenic groups, HKU1, NL63, 229E and OC43. The case mortality rate of this pandemic is 1.68%, compared to other pandemics in their first outbreaks, including the great pandemic influenza (0.2%), SARS-CoV (10%), MERS-CoV (34%), and Ebola (50%). Laboratory findings related to COVID-19 include elevated levels of D-dimer, Alanine transaminase (ALT), LDH (lactate dehydrogenase), C-reactive protein (CRP), creatine kinase and prothrombin times. Conclusion: This comparison based review will help to understand the biology, potential risk and preventive measures of COVID-19 and provide cognizance about what we need to do against this pandemic which victimized more than 200 countries up to the present time.

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