Nephrotic syndrome as a clinical manifestation of systemic sclerosis

Wielosz, Ewa; Majdan, Maria; Suszek, Dorota; Smarz-Widelska, Iwona; Korolczuk, Agnieszka; Korobowicz, E

doi:10.1007/s00296-007-0340-7

Cited by 8 publications

(2 citation statements)

References 5 publications

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“…25 Mesangial proliferative glomerulonephritis, immunoglobulin M nephropathy, and minimal change nephropathy were present in our patients. Membranous glomerulonephritis has been reported in patients with SSc, 26 but this type of renal damage was not present in our patients. Interestingly, we identified a patient who had LN and comorbid SRC.…”

Section: Discussioncontrasting

confidence: 77%

Patterns of renal pathology in Chinese patients with systemic sclerosis undergoing renal biopsy at a tertiary medical center

Cao

et al. 2019

J Int Med Res

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Objective We investigated renal injury characteristics in Chinese patients with systemic sclerosis (SSc) who had undergone renal biopsy. Methods We searched the medical records of patients with SSc who were hospitalized at Peking Union Medical College Hospital between January 1990 and August 2019. We analyzed the clinical characteristics and pathological results of these patients. Results We identified 25 patients who had undergone renal biopsy. Of these patients, 10 had scleroderma renal crisis (SRC); one underwent renal biopsy twice (for diffuse mesangial proliferative glomerulonephritis and for SRC); two had antineutrophil cytoplasmic antibody-associated glomerulonephritis; one had immunoglobulin M nephropathy; one had minimal change nephropathy; seven had lupus nephritis; one had scleroderma renal crisis with comorbid lupus nephritis; and two had drug-related kidney injury (caused by aristolochic acid in one and D-penicillamine in the other). Acute tubular necrosis was observed in the patient taking oral aristolochic acid, while minimal change nephropathy was observed in the patient with D-penicillamine-induced renal injury. Conclusions SRC was the most commonly encountered renal damage in patients with SSc. We recommend biopsy for patients undergoing treatment for SRC who have persistent renal injury with proteinuria, regardless of hematuria. Rheumatologists in Eastern countries should be aware of aristolochic acid nephropathy.

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Section: Discussioncontrasting

confidence: 77%

Patterns of renal pathology in Chinese patients with systemic sclerosis undergoing renal biopsy at a tertiary medical center

Cao

et al. 2019

J Int Med Res

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“…In addition to SLE, other autoimmune diseases have been associated with MN, including sarcoidosis (38,93,94), urticarial vasculitis (38,95), ANCA-associated glomerulonephritis (38,96), rheumatoid arthritis (38,97), Sjogren syndrome (38,98,99), systemic sclerosis (38,100,101), thyroiditis (38,102,103), chronic inflammatory demyelinating polyneuropathy (CIDP) (104-106), autoimmune myositis (99,106), and ankylosing spondylitis (38). Therefore, patients with a positive ANA, systemic manifestations, and MN should undergo a thorough workup to exclude autoimmune disease.…”

Section: Additional Autoimmune Diseases Associated With Mnmentioning

confidence: 99%

How Times Have Changed! A Cornucopia of Antigens for Membranous Nephropathy

2021

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The identification of the major target antigen phospholipase A2 receptor (PLA2R) in the majority of primary (idiopathic) cases of membranous nephropathy (MN) has been followed by the rapid identification of numerous minor antigens that appear to define phenotypically distinct forms of disease. This article serves to review all the known antigens that have been shown to localize to subepithelial deposits in MN, as well as the distinctive characteristics associated with each subtype of MN. We will also shed light on the novel proteomic approaches that have allowed identification of the most recent antigens. The paradigm of an antigen normally expressed on the podocyte cell surface leading to in-situ immune complex formation, complement activation, and subsequent podocyte injury will be discussed and challenged in light of the current repertoire of multiple MN antigens. Since disease phenotypes associated with each individual target antigens can often blur the distinction between primary and secondary disease, we encourage the use of antigen-based classification of membranous nephropathy.

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Long-term follow-up after nonmyeloablative allogeneic hematopoietic stem cell transplantation for systemic sclerosis

et al. 2008

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Systemic sclerosis (SSc) characteristically consists of fibrotic changes in various organs, and immunological abnormality is the main cause of the disease. Although high-dose immunosuppressive therapies with autologous or allogeneic hematopoietic stem cell support can reverse the disease course, they have a high treatment-related mortality. We report the successful use of nonmyeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for SSc. A 40-year-old woman with diffuse scleroderma and interstitial pneumonia underwent allogeneic peripheral blood stem cell transplantation from an HLA-identical sibling after conditioning with low-dose total-body irradiation and fludarabine. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporine and mycophenolate mofetil. No infection or acute GVHD developed. One year after transplantation, the patient developed membranous glomerulopathy caused by chronic GVHD that was successfully treated with prednisolone. The patient's skin score decreased dramatically, and her pulmonary function is stable 4 years after transplantation. Nonmyeloablative allogeneic HSCT may be more effective than conventional therapies for SSc.

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Nephrotic syndrome as a clinical manifestation of systemic sclerosis

Cited by 8 publications

References 5 publications

Patterns of renal pathology in Chinese patients with systemic sclerosis undergoing renal biopsy at a tertiary medical center

Patterns of renal pathology in Chinese patients with systemic sclerosis undergoing renal biopsy at a tertiary medical center

How Times Have Changed! A Cornucopia of Antigens for Membranous Nephropathy

Long-term follow-up after nonmyeloablative allogeneic hematopoietic stem cell transplantation for systemic sclerosis

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