Renal Involvement in Mixed Connective Tissue Disease

Abstract

5 cases with the compatible serological criteria of mixed connective tissue disease described earlier are presented. In 1 of them with a moderate degree of proteinuria, the renal biopsy disclosed membranous nephritis. However, despite the absence of overt clinical renal disease in the other 4 cases, biopsies disclosed membranous nephritis in 1 and mild mesangial proliferative glomerulonephritis in the remaining 3 cases. In the follow-up of these 4 cases, 2 subsequently developed abnormal urinalysis. Electron microscopic examinations demonstrated electron-dense deposits in glomeruli, and 4 of these patients also had microtubular structures in the endothelial cytoplasm. Contrarily to the original concept, our findings suggest that mixed connective tissue disease also induces immune complex disease.

Impact of Hypertension and Hypertension-Related Vascular Lesions in IgA Nephropathy

“…The duration of abnormal urinalysis prior to biopsy was 4.7 years (range 0. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The mean Ccr was 84.4 ml/min/1.73 m 2 (range 24.3-156.9).…”

“…Some nephrologists consider that this policy results in early detection of glomerular disease (6), but others doubt the necessity for renal biopsy in patients with isolated hematuria (7)(8)(9). Indeed, unexpectedly severe renal injury has been observed in the absence of clinically overt proteinuria (10,11).…”

A case of mixed connective tissue disease presenting with nephrotic syndrome

“…However, recently the ratio of renal involvement in patients with MCTD has been reported to be between 10% and 50%. [3][4][5] The renal changes usually take the form of membranous glomerulonephritis. In a series in which 40% of the patients with MCTD showed renal involvement, NS occurred in 75% of patients with renal involvement, mainly in association with membranous nephropathy.…”

“…This finding was outstanding in one case of MCTD and was assumed to be mainly due to the SLE component. 5,6 The most characteristic lesions of SSc involve the interlobular arteries and consist of concentric internal thickening with hyperplastic intimal cells in a loose mucoid ground substance. [8][9][10] The lesions in interlobular arteries in this case were not as severe as those of typical SSc.…”

Pregnancy Outcome in Nephrotic Syndrome with Mixed Connective Tissue Disease

“…Reports describing pregnancies in patients with MCTD are rare, and the results have been contradictory: a high risk of fetal loss and of disease exacerbation or no influence on fetus or mother [2, 3, 4, 5]. Renal involvement in MCTD has been considered by some authors [6, 7, 8, 9, 10, 11, 12, 13]. We report here a patient with nephrotic syndrome secondary to MCTD and describe the course of her disease during pregnancy.…”