Clinico-histomorphologic Characteristics of Lupus Nephritis, Experience at a Center at Dhaka

Islam, Sk MdJaynul; Rahman, A. K. M.Mijanur; Yasmin, Shamoli; Giti, Susane

doi:10.4103/1319-2442.352438

Cited by 2 publications

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“…The histopathological classification of LN revealed that class IV (diffuse proliferative glomerulonephritis) was the most common, consistent with current literature [ 37 ]. Importantly, this classification was associated with a higher urinary protein excretion, more frequent use of cyclophosphamide, and positive direct Coomb’s test.…”

Section: Discussionsupporting

confidence: 88%

Clinical and laboratory characteristics of early-onset and delayed-onset lupus nephritis patients: A single-center retrospective study

Kosałka-Węgiel,

Dziedzic,

Siwiec-Koźlik

et al. 2024

Rheumatol Int

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Background Lupus nephritis (LN) manifests systemic lupus erythematosus (SLE) and is characterized by various clinical and laboratory features. This study aimed to comprehensively evaluate the characteristics of LN patients according to the time of LN diagnosis: early-onset (LN diagnosed within one year from SLE diagnosis) vs. delayed-onset (LN diagnosed more than one year after SLE diagnosis). Methods We conducted a retrospective analysis of medical records from all SLE patients treated at the University Hospital in Kraków, Poland, from 2012 to 2022. We collected data on demographic, clinical, and laboratory characteristics, including histological findings, treatment modalities, and disease outcomes. Statistical analyses were performed to identify factors impacting LN development and prognosis. Results Among 331 LN patients, early-onset was diagnosed in 207 (62.54%) and delayed-onset was documented in 122 cases (36.86%). In 2 (0.6%) LN cases, the time of first kidney manifestation in the SLE course was unknown. Delayed-onset LN had a higher female-to-male ratio and younger age at SLE diagnosis. This group was associated with more severe clinical manifestations. In turn, studied subgroups did not differ in internist comorbidities, kidney histopathology, and family history regarding autoimmune diseases. Delayed-onset LN exhibited a higher frequency of anti-dsDNA, anti-Smith, anti-Ro, anti-RNP, and anti-cardiolipin IgG autoantibodies. During a 14-year follow-up period, 16 patients died. Mortality rate and causes of death were comparable in both analyzed subgroups. Conclusions More severe clinical manifestations in delayed-onset LN prompt strict monitoring of non-LN SLE patients to diagnose and treat kidney involvement early. Also, recognizing the higher frequency of autoantibodies such as anti-dsDNA or anti-Smith in delayed-onset LN underscores the potential value of autoantibody profiling as a diagnostic and prognostic tool.

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Section: Discussionsupporting

confidence: 88%

Clinical and laboratory characteristics of early-onset and delayed-onset lupus nephritis patients: A single-center retrospective study

Kosałka-Węgiel,

Dziedzic,

Siwiec-Koźlik

et al. 2024

Rheumatol Int

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Comparison of Histomorphological Indices Between Adult and Pediatric Patients in Response to Induction Therapy

Murugesan,

Mathew,

Rajasekharan Nair

et al. 2024

Cureus

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Background: Renal involvement, known as lupus nephritis (LN), is a common and serious complication of systemic lupus erythematosus (SLE), linked to significant morbidity and mortality. Histomorphological indices, such as the activity index (AI) and chronicity index (CI), are critical in predicting treatment responses and outcomes. This study aims to compare these histomorphological indices between adult and pediatric patients with LN and evaluate their impact on post-induction therapy outcomes. Methods: A cross-sectional analysis was conducted at a single nephrology department from 2005 to 2019, including patients with biopsy-confirmed LN. Data on demographic characteristics, histomorphological indices, and clinical outcomes post-induction therapy were collected. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States) to identify significant correlations and differences. Results: Pediatric patients exhibited significantly lower AI (p=0.042) and CI scores compared to adults. Lower frequencies of hyaline thrombi (p=0.005) and tubular atrophy (p=0.028) were observed in the pediatric group. Key predictors of a complete response to induction therapy included interstitial inflammation <0.65 and tubular atrophy <0.63. Significant correlations were found between post-induction renal function tests (RFT) and indices such as AI (p=0.035), CI (p<0.001), cellular and fibrocellular crescents (p<0.001), and tubular atrophy (p<0.001). Proteinuria outcomes were significantly associated with CI (p=0.040), interstitial inflammation (p=0.006), and tubular atrophy (p=0.026). Conclusion: The conclusion aligns with the established understanding that pediatric patients with LN often have a different disease trajectory compared to adults. Pediatric patients generally presented with less severe histomorphological damage, contributing to better responses to induction therapy. Detailed histopathological assessments are essential for guiding treatment strategies and improving patient prognosis in both adult and pediatric LN populations.

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Clinico-histomorphologic Characteristics of Lupus Nephritis, Experience at a Center at Dhaka

Cited by 2 publications

References 0 publications

Clinical and laboratory characteristics of early-onset and delayed-onset lupus nephritis patients: A single-center retrospective study

Clinical and laboratory characteristics of early-onset and delayed-onset lupus nephritis patients: A single-center retrospective study

Comparison of Histomorphological Indices Between Adult and Pediatric Patients in Response to Induction Therapy

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