scholarly journals Clinicopathological characteristics of segmental (IV-S) and global (IV-G) active subclasses of class IV lupus nephritis: a comparative study

2014 ◽  
Vol 3 ◽  
pp. 223-228
Author(s):  
Małgorzata Wągrowska-Danilewicz ◽  
Marian Danilewicz
Keyword(s):  
Lupus Nephritis ◽  
Comparative Study ◽  
Clinicopathological Characteristics ◽  
Class Iv

scholarly journals Initial renal histology and early response predict outcomes of Brazilian lupus nephritis patients

Lupus ◽  
2019 ◽  
Vol 29 (1) ◽  
pp. 83-91
Author(s):  
G Vajgel ◽  
C B L Oliveira ◽  
D M N Costa ◽  
M A G M Cavalcante ◽  
L M Valente ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Lupus Nephritis ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Estimated Glomerular Filtration Rate ◽  
Interstitial Fibrosis ◽  
End Stage ◽  
Class Iv

Objective We analyzed baseline and follow-up characteristics related to poorer renal outcomes in a Brazilian cohort of admixture race patients with lupus nephritis. Methods Overall, 280 outpatients with a diagnosis of systemic lupus erythematosus and previous kidney biopsy of lupus nephritis were recruited from August 2015 to December 2018 and had baseline laboratory and histologic data retrospectively analyzed; patients were then followed-up and data were recorded. The main outcome measure was the estimated glomerular filtration rate at last follow-up. Secondary analyses assessed the impact of initial kidney histology and treatment in long-term kidney survival. Results Median duration of lupus nephritis was 60 months (interquartile range: 27–120); 40 (14.3%) patients presented progressive chronic kidney disease (estimated glomerular filtration rate <30 and ≥10 ml/min/1.73 m2) or end-stage kidney disease at last visit. Adjusted logistic regression analysis showed that class IV lupus nephritis (odds ratio 14.91; 95% confidence interval 1.77–125.99; p = 0.01) and interstitial fibrosis ≥25% at initial biopsy (odds ratio 5.87; 95% confidence interval 1.32–26.16; p = 0.02), lack of complete or partial response at 12 months (odds ratio 16.3; 95% confidence interval 3.74–71.43; p < 0.001), and a second renal flare (odds ratio 4.49; 95% confidence interval 1.10–18.44; p = 0.04) were predictors of progressive chronic kidney disease. In a Kaplan-Meier survival curve we found that class IV lupus nephritis and interstitial fibrosis ≥25% were significantly associated with end-stage kidney disease throughout follow-up (hazard ratio 2.96; 95% confidence interval 1.3–7.0; p = 0.036 and hazard ratio 4.96; 95% confidence interval 1.9–12.9; p < 0.0001, respectively). Conclusion In this large cohort of admixture race patients, class IV lupus nephritis and chronic interstitial damage at initial renal biopsy together with non-response after 1 year of therapy and relapse were associated with worse long-term renal outcomes.

Characteristics and influence factors of pathologic transformation in the subclasses of class IV lupus nephritis

2011 ◽  
Vol 32 (6) ◽  
pp. 1751-1759 ◽  
Author(s):  
Jian-jun Gao ◽  
Guang-yan Cai ◽  
Shu-wen Liu ◽  
Li Tang ◽  
Xue-guang Zhang ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Influence Factors ◽  
Class Iv

Transformation of Recurred Lupus Nephritis from Class IV to Class V

2012 ◽  
Vol 19 (5) ◽  
pp. 290
Author(s):  
Jin-Ju Park ◽  
Ji-Yeong Kwak ◽  
Ju-Yang Jung ◽  
Bo-Ram Koh ◽  
Hyoun-Ah Kim ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Class V ◽  
Class Iv

scholarly journals A Rare Neurological Complication - Posterior Reversible Encephalopathy Syndrome in a Patient with Systemic Lupus Erythematosus and Class IV Lupus Nephritis

2018 ◽  
Vol 15 (4) ◽  
pp. 27-34
Author(s):  
Anna Mirela Stroie ◽  
Mircea Nicolae Penescu
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Immunosuppressive Therapy ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Lupus Erythematosus ◽  
Neurological Complication ◽  
Systemic Lupus ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Class Iv

AbstractPosterior reversible encephalopathy syndrome is a rare manifestation of systemic lupus erythematosus, characterized by altered mental status, headache, convulsions, visual field impairment and posterior and reversible alterations on imaging scans(1,2). The clinical picture develops over a few hours, presenting with rapidly progressive neurological symptoms(3). It was first described in 1996. It is more frequent in patients with acute kidney injury or chronic kidney disease, thus in lupus patients with kidney disorders. It is associated with hypertension, other autoimmune diseases beside lupus, immunosuppressive therapies, especially antibody-based immunosuppressive therapy, and organ transplantation. It is clinically reversible within one week and imaging changes resolve within 2-4 weeks. It is treatable and has a good prognosis. We present the case of a young woman of 27 years, diagnosed with systemic lupus erythematosus who developed convulsive seizures, headache, visual impairment, being under immunosuppressive therapy with azathioprine. The kidney biopsy revealed class IV lupus nephritis and partial remission of the nephrotic syndrome. The other manifestations of SLE in this patient were cutaneous, immunological, articular and haematological. The patient had a good short, medium and long-term prognosis at 30 days and also at 6 months.

scholarly journals AB0018 Clinical status and gene expression in class iv lupus nephritis

2018 ◽  
Author(s):  
L.A. Mas ◽  
V. Saurit ◽  
E. Palomino ◽  
J.L. De la Fuente ◽  
M. Angelina ◽  
...  
Keyword(s):  
Gene Expression ◽  
Lupus Nephritis ◽  
Clinical Status ◽  
Class Iv

scholarly journals P0897RISK FACTORS FOR AVASCULAR BONE NECROSIS IN PATIENTS WITH LUPUS NEPHRITIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Daniela Monova ◽  
Simeon Monov ◽  
Assen Kamenov ◽  
Vladislava Milenova
Keyword(s):  
Risk Factors ◽  
Lupus Nephritis ◽  
Avascular Necrosis ◽  
Immunosuppressive Agents ◽  
Individual Risk ◽  
Control Group ◽  
High Dose ◽  
Increased Risk ◽  
Avascular Necrosis Of Bone ◽  
Class Iv

Abstract Background and Aims Avascular necrosis of bone (AVN) is an important complication of systemic lupus erythematosus (SLE) and often causes serious physical disability. The aim of this study was to investigate the risk factors for symptomatic avascular necrosis of bone (AVN) in lupus nephritis (LN) patients. Method The records of 374 patients (43 males, 331 females) with kidney biopsy-proven LN were reviewed retrospectively. Symptomatic AVN cases were defined as those with at least one diagnosis of AVN. The patients with LN who did not have AVN were evaluated as a control group. To determine risk factors for AVN, clinical, laboratory and therapeutic variables were analyzed by logistic regression. Results Symptomatic AVN was present in 17 patients (4 males, 13 females, mean age of 27,4±6,7 years). Among the 17 patients, 28 joints presented AVN. 12 occurred in hips (2 bilateral), 6-in ankles, 4-in knees, 3-in shoulders and 1- in lumbar spine. In 9 patients AVN involved 2 or more joints. 14 patients were on steroids at the time of presentation of AVN. 2 patients were not on CS and 1 patient did not has documentation of steroid use. Meta-analysis demonstrates a significant increased risk of AVN in patients with high disease activity and class IV LN (p&lt;0,005). LN patients with AVN showed an earlier onset age (p&lt;0,05) and received significantly higher total cumulative corticosteroid dose. AVN was not significantly associated with use of immunosuppressive agents. Serositis, coagulation disorders, vasculitis, cigarette smoking were higher incidence in male with LN and AVN. Raynaud‘s phenomenon, autoimmune thyroiditis, arthritis, Sjögren’s syndrome, IgM anticardiolipin antibodies, antiphospholipid syndrome, Cushingoid body habitus were higher incidence in female with LN and AVN. Conclusion Many risk factors have been involved in the development of AVN in LN patients. AVN is prevalent in class IV LN and in younger patients. Since asymptomatic osteonecrosis may remain undetected, its true prevalence could be much higher than we reported. Multifocal lesions involving more than three anatomical sites are unusual. Corticosteroids are the principal risk factor, although some cases of AVN occur in relatively steroid naïve patients. Early detection of AVN is important because the prognosis depends of the stage and location of the lesion. An individual risk assessment for AVN development should be made prior to and during treatment for LN, especially in patients high dose corticosteroids.

scholarly journals Analysis of clinical risk factors in relapsed patients with class IV lupus nephritis

2018 ◽  
Author(s):  
Jing Wang ◽  
Yuan‑Yuan Qi ◽  
Xue‑Ping Chen ◽  
Li Ma ◽  
Li‑Li Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lupus Nephritis ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Class Iv

The correlation of urinary podocytes and podocalyxin with histological features of lupus nephritis

Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 484-493 ◽  
Author(s):  
D Ikuma ◽  
K Hiromura ◽  
H Kajiyama ◽  
J Suwa ◽  
H Ikeuchi ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Sandwich Elisa ◽  
Characteristic Analysis ◽  
Crescent Formation ◽  
Class V ◽  
Histological Features ◽  
Cellular Crescent ◽  
Class Iv

Objectives The objective of this study was to test the correlation of urinary podocyte number (U-Pod) and urinary podocalyxin levels (U-PCX) with histology of lupus nephritis. Methods This was an observational, cross-sectional study. Sixty-four patients were enrolled: 40 with lupus nephritis and 24 without lupus nephritis (12 lupus nephritis patients in complete remission and 12 systemic lupus erythematosus patients without lupus nephritis). Urine samples were collected before initiating treatment. U-Pod was determined by counting podocalyxin-positive cells, and U-PCX was measured by sandwich ELISA, normalized to urinary creatinine levels (U-Pod/Cr, U-PCX/Cr). Results Lupus nephritis patients showed significantly higher U-Pod/Cr and U-PCX/Cr compared with patients without lupus nephritis. U-Pod/Cr was high in proliferative lupus nephritis (class III±V/IV±V), especially in pure class IV (4.57 (2.02–16.75)), but low in pure class V (0.30 (0.00–0.71)). U-Pod/Cr showed a positive correlation with activity index ( r=0.50, P=0.0012) and was independently associated with cellular crescent formation. In contrast, U-PCX/Cr was high in both proliferative and membranous lupus nephritis. Receiver operating characteristic analysis revealed significant correlation of U-Pod/Cr with pure class IV, class IV±V and cellular crescent formation, and the combined values of U-Pod/Cr and U-PCX/Cr were shown to be associated with pure class V. Conclusions U-Pod/Cr and U-PCX/Cr correlate with histological features of lupus nephritis.

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