A clinico-pathological study of renal biopsy in systemic lupus erythematosus (SLE)

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A clinico-pathological study of renal biopsy in systemic lupus erythematosus (SLE)

Journal Title: Medpulse International Journal of Pathology - Year 2018, Vol 8, Issue 3

Abstract

Background: Renal biopsies play an important role in the diagnosis, management and prognosis of patients with lupus nephritis (LN). objectives: To determine the correlation between the histopathological features of LN and the demographic, clinical and laboratory parameters. Patients and Methods: This cross-sectional retrospective study was conducted from January 2017 to December 2018 on all consecutive cases of biopsy-proven LN at Dr. Deshpande nephoropatholgoy laboratory in Pune. The demographic, clinical and laboratory data were obtained from nephrologist original biopsy request forms. International Society of Nephrology and the Renal Pathology Society (ISN/RPS) classification 2003 is followed. Results: Of the 110 patients enrolled, 102 (92.73%) were female and 8(7.27%) were male. The commonest age group affected was between 20 to 30 years (44.55%). The majority of patients belonged to class III(23.64%) and class IV (30.91%). Edema(100%) was the commonest symptom followed by arthralgia (62.73%), fever(50.0%),malarrash(45.5%),hypertension(42.7%)and photosensitivity(17.27%). Bloodurea level, serum creatinine level and urine protein/creatinine ratio(UPCR) had statistically significant correlation with the class of LN(p=0.016;p=0.057;p=0.001 respectively). Active urinary sediment was noted in more than 50% cases of LN.Nephrotic range proteinuria was common in class III LN(61.5%) and class IV LN(64.7%) .The Activity Index(AI) and Chronicity Index (CI) had statistically significant correlation with class of LN(p=0.001).Highest AI was found in class III LN(mean value 6.12) and class IV LN(mean value 13.47) ,whereas the highest CI was found in class VI LN(mean value 10.5).No statistically significant differences were found among subclasses of class IV LN(class IV-S and class IV-G) with respect to hemoglobin concentration, serum creatinine level, twenty four hour proteinuria, AI, CI, hematuria, hypertension and UPCR. Among immunological parameters IgG,C3 and C1q demonstrated highest percent positivity among various classes of LN(Table no.10) Conclusions: In conclusion, the results from our study on biopsy-proven cases of LN largely concur with the previously reported studies .

Authors and Affiliations

Prashant G Mankar, Sunil G Deshpande

Keywords

Urine Protein/Creatinine Ratio(UPCR);Activity Index(AI); Chronicity Index(CI); Anti-Nuclear Antibody(ANA);Lupus Nephritis(LN);Systemic Lupus Erythematosus(SLE).

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EP ID EP457927
DOI 10.26611/105837
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