Kidney Disease in Antiphospholipid Syndrome

Kidney disease in primary anti-phospholipid antibody syndrome

“…There are numerous classifications for renal manifestations of APLN, based on their location [44]. They can be divided in three main groups, each having its own pathogenic, clinical and diagnostic characteristics: renal artery lesions, secondary to thrombosis, stenosis or occlusion of the main artery (uni-or bilateral); intrarenal vascular lesions (require biopsy confirmation); and renal vein thrombosis (Fig.…”

“…In addition to laboratory tests, renal scintigraphy and selective renal angiography facilitates the confirmation of the diagnosis and the extent of the lesions [44].…”

“…Other histopathologic findings have been described, but these are not specific for APLN [44] (Table 1).…”

“…The most commonly reported and characteristic intrarenal vascular lesion, in patients with APS [34, 44,6871] is TMA, characterized by the presence of distinctive microscopic and ultrastructural changes [72]. The most common clinical features of TMA include: hypertension, www.rheumatology.oxfordjournals.org proteinuria and renal impairment.…”

“…Other conditions including thrombotic thrombocytopenic purpura, haemolytic uremic syndrome, post-partum renal failure, pre-eclampsia/eclampsia, scleroderma, malignant arterial hypertension or drugs (ciclosporin, chemotherapy, contraceptives), can produce similar lesions. The morphologic lesions are insufficient to make an aetiologic diagnosis, and require additional clinical and laboratory data, including aCL and LA determination, as well as exclusion of colibacillary infections, chronic hypertension, systemic sclerosis among others [44,75].…”