Renal involvement in systemic lupus erythematosus: additional histopathological lesions

Muniz, Monique Pereira Rêgo; Brito, Laíse Pereira Arcoverde Fechine; Vale, Pedro Henrique Cavalcante; Guedes, Felipe Leite; Oliveira, Thina Klicia Mendonça; Brito, Dyego José de Araújo; Filho, Natalino Salgado; Dantas, Márcio; Silva, Gyl Eanes Barros

doi:10.5114/aoms.2020.96617

Cited by 3 publications

(2 citation statements)

References 80 publications

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“…In a Chinese study of the lupus population, renal thrombotic microangiopathy had a prevalence of 24.3% (25). This finding is higher to those previously reported, whose prevalence varied between 0.5 and 10% of cases (26). In some studies, lupus nephritis progression in TMA cases was worse than in cases without TMA (26).…”

Section: Discussioncontrasting

confidence: 77%

Multisystemic Inflammatory Syndrome and Thrombotic Microangiopathy as Complications of COVID-19 in a Child: A Case Report

Muniz

Faria

et al. 2021

Front. Pediatr.

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Clinical presentations of the novel coronavirus (SARS-CoV-2) infection are quite varied, ranging from asymptomatic conditions to potentially fatal disease. The kidney is one of the affected targets of coronavirus disease (COVID-19) complications, and renal dysfunction is a significant prognostic factor for mortality. This report describes a series of clinical complications in a previously healthy child who developed nephritic syndrome with a concomitant SARS-CoV-2 infection. These complications include acute kidney injury that progressed to chronicity, multisystemic inflammatory syndrome, Kawasaki-like syndrome, and thrombotic microangiopathy.

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Section: Discussioncontrasting

confidence: 77%

Multisystemic Inflammatory Syndrome and Thrombotic Microangiopathy as Complications of COVID-19 in a Child: A Case Report

Muniz

Faria

et al. 2021

Front. Pediatr.

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“…Lupus nephritis is categorized into six classes based on the International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification: Class I (minimal mesangial lupus nephritis), Class II (mesangial proliferative lupus nephritis), Class III (focal lupus nephritis), Class IV (diffuse lupus nephritis), Class V (membranous lupus nephritis), and Class VI (advanced sclerosing lupus nephritis). Class IV is the most common and severe form, often leading to chronic kidney disease (CKD) and end-stage renal disease (ESRD) [ 4 ]. Patients with lupus nephritis typically present with proteinuria, hematuria, and varying degrees of renal impairment.…”

Section: Discussionmentioning

confidence: 99%

Unmasking Focal Segmental Glomerulosclerosis in a Patient With Lupus Nephritis

Acob,

Jumaah,

Kakhktsyan

et al. 2024

Cureus

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Systemic lupus erythematosus (SLE) is a persistent autoimmune disease where the immune system produces autoantibodies against nuclear and cytoplasmic antigens, leading to multi-organ involvement. Typically, nephrotic-range proteinuria is indicative of proliferative or membranous lupus nephritis. However, on rare occasions, patients with SLE and nephrotic syndrome may exhibit focal segmental glomerulosclerosis (FSGS) lesions upon kidney biopsy. We describe a 28-year-old Middle Eastern male with SLE and biopsy-proven lupus nephritis who experienced a significant increase in proteinuria and creatinine levels despite treatment with mycophenolate mofetil. Further investigation revealed FSGS without active lupus nephritis. The patient's treatment regimen was adjusted to rituximab in response to these findings. This case underscores the importance of renal biopsies in SLE management to accurately diagnose and tailor treatment. It highlights the need to consider alternative renal complications, such as FSGS, which can coexist with lupus nephritis, necessitating a collaborative approach between rheumatologists and nephrologists to achieve optimal patient outcomes.

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Dynamics of CD4+ and CD8+ Lymphocytic Inflammatory Infiltrates in Lupus Nephritis

Azoicăi,

Avădănei,

Giusca

et al. 2024

IJMS

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Lupus nephritis (LN) is a common clinical manifestation of systemic lupus erythematosus (SLE). Our study aims to quantitatively analyze CD4+ and CD8+ lymphocytes in different areas and LN classes and describe a specific distribution pattern that is correlated with the severity of LN-specific lesions. In total, 53 LN renal biopsies were immunohistochemically investigated using anti-CD4 and anti-CD8 antibodies. T lymphocytes were counted in 3 areas, including intraglomerular, periglomerular, and interstitial regions. The severity of glomerular and tubulo-interstitial lesions was assessed using an original semi-quantitative algorithm based on the renal corpuscle score (RC_S) and the tubulo-interstitial score (TI_S). The number of CD8+ T lymphocytes was higher than that of CD4+ T lymphocytes in each of the three areas and in each LN class, showing statistically significant differences. ANOVA analysis of all LN classes showed significant differences between periglomerular and interstitial CD4+ and CD8+ T lymphocytes, respectively. Irrespective of location, the number of CD8+ T lymphocytes statistically correlates with the RC_S and the TI_S; no significant correlations were found between the number of CD4+ T lymphocytes and the RC_S and the TI_S for all three considered areas. Our data provide strong evidence supporting the major role of CD8+ lymphocytes in LN lesion progression, with CD4+ lymphocytes playing a limited role.

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Renal involvement in systemic lupus erythematosus: additional histopathological lesions

Cited by 3 publications

References 80 publications

Multisystemic Inflammatory Syndrome and Thrombotic Microangiopathy as Complications of COVID-19 in a Child: A Case Report

Multisystemic Inflammatory Syndrome and Thrombotic Microangiopathy as Complications of COVID-19 in a Child: A Case Report

Unmasking Focal Segmental Glomerulosclerosis in a Patient With Lupus Nephritis

Dynamics of CD4+ and CD8+ Lymphocytic Inflammatory Infiltrates in Lupus Nephritis

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