Keywords
lupus nephritis, clinical and histological comparisons, renal biopsy, histopathological examination
How to Cite
Trypilka, S., Golovach, I., & Diadyk, E. (2018). LUPUS GLOMERULONEPHRITIS: AT CROSSING OF CLINICAL AND HISTOLOGICAL DIAGNOSIS. The Practitioner, (4), 22-29. Retrieved from https://plr.com.ua/index.php/journal/article/view/39
Abstract
The article presents modern approaches to the diagnosis of lupus nephritis. Pathological changes are described, and characteristics of the lupus nephritis classes are given. The results of a histological examination of a kidney biopsy are the only reliable method for lupus nephritis diagnosing that is absolutely necessary for initiating therapy, since in most cases there are no clinical, laboratory or serological studies that can predict/replace the results of a renal biopsy with sufficient accuracy. To date, none of the serum or urinary biomarkers of the disease activity exceeds the information content obtained by histopathological examination of kidney biopsies. The presence of nephritis in patients with SLE is suspected based on an abnormal urine test and/or an increase serum creatinine; the diagnosis is confirmed by histological data from a renal biopsy. A kidney biopsy should be performed in most patients with SLE who have signs of kidney damage, not only for the purpose of diagnosis, but also for the lupus nephritis class. According to the results of a biopsy of the kidney, it is possible to establish the severity and activity of kidney damage, the involvement of the vessels and the tubular apparatus of the kidney; also identify alternative causes of renal failure. Thus, the classification of lupus glomerulonephritis is determined by the results of pathological studies. The article is illustrated with photographs of histopathological changes of the kidneys in various classes of nephritis.
References
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18. Jennette J.C., Iskandar S.S., Dalldorf F.G. Pathologic differentiation between lupus and nonlupus membranous glomerulopathy // Kidney Int. — 1983. — Vol. 24. — P. 377-385.
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21. Kasitanon N., Magder L.S., Petri M. Predictors of survival in systemic lupus erythematosus // Medicine (Baltimore). — 2006. — Vol. 85. — P. 147-156.
22. Lee H.S., Mujais S.K., Kasinath B.S. et al. Course of renal pathology in patients with systemic lupus erythematosus // Am. J. Med. — 1984. — Vol. 77. — P. 612-620.
23. Lloyd W., Schur P.H. Immune complexes, complement, and anti-DNA in exacerbations of systemic lupus erythematosus (SLE) // Medicine (Baltimore). — 1981. — Vol. 60. — P. 208-217.
24. Lu J., Tam L.S., Lai F.M. et al. Repeat renal biopsy in lupus nephritis: a change in histological pattern is common // Am. J. Nephrol. — 2011. — Vol. 34. — P. 220-225.
25. Mannik M., Merrill C.E., Stamps L.D., Wener M.H. Multiple autoantibodies form the glomerular immune deposits in patients with systemic lupus erythematosus // J. Rheumatol. — 2003. — Vol. 30. — P. 1495-1504.
26. Najafi C.C., Korbet S.M., Lewis E.J. et al. Significance of histologic patterns of glomerular injury upon long-term prognosis in severe lupus glomerulonephritis // Kidney Int. — 2001. — Vol. 59. — P. 2156-2163.
27. Nossent H.C., Henzen-Logmans S.C., Vroom T.M., et al. Contribution of renal biopsy data in predicting outcome in lupus nephritis. Analysis of 116 patients // Arthritis Rheum. — 1990. — Vol. 33. — P. 970-977.
28. Ortega L.M., Schultz D.R., Lenz O. et al. Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions // Lupus. — 2010. — Vol. 19. — P. 557-574.
29. Parikh S.V., Rovin B.H. Current and Emerging Therapies for Lupus Nephritis // J. Am. Soc. Nephrol. — 2016. — Vol. 27. — P. 2929-2939.
30. Rich S.A. De novo synthesis and secretion of a 36-kD protein by cells that form lupus inclusions in response to alpha-interferon // J. Clin. Invest. — 1995. — Vol. 95. — P. 219-226.
31. Rovin B.H., Zhang X. Biomarkers for lupus nephritis: the quest continues // Clin. J. Am. Soc. Nephrol. — 2009. — Vol. 4. — P. 1858-1865.
32. Rubinstein T., Pitashny M., Levine B., et al. Urinary neutrophil gelatinase-associated lipocalin as a novel biomarker for disease activity in lupus nephritis // Rheumatology (Oxford). — 2010. — Vol. 49. — P. 960-971.
33. Schwartz M.M., Kawala K.S., Corwin H.L., Lewis E.J. The prognosis of segmental glomerulonephritis in systemic lupus erythematosus // Kidney Int. — 1987. — Vol. 32. — P. 274-279.
34. Schwartz M.M., Korbet S.M., Lewis E.J., Collaborative Study Group. The prognosis and pathogenesis of severe lupus glomerulonephritis // Nephrol. Dial. Transplant. — 2008. — Vol. 23. — P. 1298-1306.
35. Schwartz M.M., Lan S.P., Bonsib S.M., et al. Clinical outcome of three discrete histologic patterns of injury in severe lupus glomerulonephritis // Am. J. Kidney Dis. — 1989. — Vol. 13. — P. 273-283.
36. Schwartz N., Rubinstein T., Burkly L.C., et al. Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study // Arthritis Res. Ther. — 2009. — Vol. 11 (5). — R143.
37. Seligman V.A., Lum R.F., Olson J.L., et al. Demographic differences in the development of lupus nephritis: a retrospective analysis // Am. J. Med. — 2002. — Vol. 112. — P. 726-729.
38. Sen D., Isenberg D.A. Antineutrophil cytoplasmic autoantibodies in systemic lupus erythematosus // Lupus. — 2003. — Vol. 12. — P. 651-658.
39. Wang F., Wang C.L., Tan C.T., Manivasagar M. Systemic lupus erythematosus in Malaysia: a study of 539 patients and comparison of prevalence and disease xpression in different racial and gender groups // Lupus. — 1997. — Vol. 6 (3). — P. 248-253.
40. Weening J.J., D’Agati V.D., Schwartz M.M., et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited // Kidney Int. — 2004. — Vol. 65 (2). — P. 521-530.
41. Yin Y., Wu X., Shan G., Zhang X. Diagnostic value of serum anti-C1q antibodies in patients with lupus nephritis: a meta-analysis // Lupus. — 2012. — Vol. 21 (10). — P. 1088-1097.
2. Дядык Е.А. Характер гломерулярных поражений при различных морфологических формах волчаночного гломерулонефрита // Вестн. неотлож. и восстанов. медицины. — 2004. — № 5 (1). — С. 116-119.
3. Дядык Е.А. Интерпретация почечных биоптатов у больных системной красной волчанкой с клиническими проявлениями волчаночного гломерулонефрита // Укр. журн. нефрології та діалізу. — 2004. — № 2. — С. 10-13.
4. Aitman T.J., Dong R., Vyse T.J. et al. Copy number polymorphism in Fcgr3 predisposes to glomerulonephritis in rats and humans // Nature. — 2006. — Vol. 439. — P. 851-856.
5. Akashi Y., Oshima S., Takeuchi A. et al. Identification and analysis of immune cells infiltrating into the glomerulus and interstitium in lupus nephritis // Nihon Rinsho Meneki Gakkai Kaishi. — 1995. — Vol. 18. — P. 545-549.
6. Alarcón G.S., McGwin G. Jr, Petri M. et al. Baseline characteristics of a multiethnic lupus cohort: PROFILE // Lupus. — 2002. — Vol. 11. — P. 95-99.
7. Almaani S., Meara A., Rovin B.H. Update on Lupus Nephritis // Clin. J. Am. Soc. Nephrol. — 2017. — Vol. 12. — P. 825-828.
8. Appel G.B., Silva F.G., Pirani C.L. et al. Renal involvement in systemic lupud erythematosus (SLE): a study of 56 patients emphasizing histologic classification // Medicine (Baltimore). — 1978. — Vol. 57. — P. 371-378.
9. Cervera R., Khamashta M.A., Font J. et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients // Medicine (Baltimore). — 2003. — Vol. 82. — P. 299-308.
10. Cervera R., Khamashta M.A., Font J. et al. Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1.000 patients. The European Working Party on Systemic Lupus Erythematosus // Medicine (Baltimore). — 1993. — Vol. 72. — P. 113-124.
11. Chung J., Bernstein J., Glassock R.J. Renal Disease: Classification and Atlas of Glomerular Disease (2nd ed). — Tokyo, New York, Igaku-Shoin, 1995. — 151 p.
12. Davis J.C., Tassiulas I.O., Boumpas D.T. Lupus nephritis // Curr Opin Rheumatol. — 1996. — Vol. 8. — P. 415-423.
13. Descombes E., Droz D., Drouet L. et al. Renal vascular lesions in lupus nephritis // Medicine (Baltimore). — 1997. — Vol. 76. — P. 355-368.
14. Donadio J.V. Jr, Burgess J.H., Holley K.E. Membranous lupus nephropathy: a clinicopathologic study // Medicine (Baltimore). — 1977. — Vol. 56. — P. 527-536.
15. Furness P.N., Taub N. Interobserver reproducibility and application of the ISN/RPS classification of lupus nephritis-a UK-wide study // Am. J. Surg. Pathol. — 2006. — Vol. 30. — P. 1030-1035.
16. Gelmetti A.P., Freitas A.C., Woronik V. et al. Polymorphism of the FcgammaRIIalpha IgG receptor in patients with lupus nephritis and glomerulopathy // J. Rheumatol. — 2006. — Vol. 33. — P. 523-530.
17. Huong D.L., Papo T., Beaufils H., et al. Renal involvement in systemic lupus erythematosus. A study of 180 patients from a single center // Medicine (Baltimore). — 1999. — Vol. 78. — P. 148-166.
18. Jennette J.C., Iskandar S.S., Dalldorf F.G. Pathologic differentiation between lupus and nonlupus membranous glomerulopathy // Kidney Int. — 1983. — Vol. 24. — P. 377-385.
19. Karassa F.B., Trikalinos T.A., Ioannidis J.P. FcgammaRIIa-SLE Meta-Analysis Investigators. Role of the Fcgamma receptor IIa polymorphism in susceptibility to systemic lupus erythematosus and lupus nephritis: a meta-analysis // Arthritis Rheum. — 2002. — Vol. 46. — P. 1563-1571.
20. Kashgarian M. Lupus nephritis: lessons from the path lab // Kidney Int. — 1994. — Vol. 45. — P. 928-938.
21. Kasitanon N., Magder L.S., Petri M. Predictors of survival in systemic lupus erythematosus // Medicine (Baltimore). — 2006. — Vol. 85. — P. 147-156.
22. Lee H.S., Mujais S.K., Kasinath B.S. et al. Course of renal pathology in patients with systemic lupus erythematosus // Am. J. Med. — 1984. — Vol. 77. — P. 612-620.
23. Lloyd W., Schur P.H. Immune complexes, complement, and anti-DNA in exacerbations of systemic lupus erythematosus (SLE) // Medicine (Baltimore). — 1981. — Vol. 60. — P. 208-217.
24. Lu J., Tam L.S., Lai F.M. et al. Repeat renal biopsy in lupus nephritis: a change in histological pattern is common // Am. J. Nephrol. — 2011. — Vol. 34. — P. 220-225.
25. Mannik M., Merrill C.E., Stamps L.D., Wener M.H. Multiple autoantibodies form the glomerular immune deposits in patients with systemic lupus erythematosus // J. Rheumatol. — 2003. — Vol. 30. — P. 1495-1504.
26. Najafi C.C., Korbet S.M., Lewis E.J. et al. Significance of histologic patterns of glomerular injury upon long-term prognosis in severe lupus glomerulonephritis // Kidney Int. — 2001. — Vol. 59. — P. 2156-2163.
27. Nossent H.C., Henzen-Logmans S.C., Vroom T.M., et al. Contribution of renal biopsy data in predicting outcome in lupus nephritis. Analysis of 116 patients // Arthritis Rheum. — 1990. — Vol. 33. — P. 970-977.
28. Ortega L.M., Schultz D.R., Lenz O. et al. Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions // Lupus. — 2010. — Vol. 19. — P. 557-574.
29. Parikh S.V., Rovin B.H. Current and Emerging Therapies for Lupus Nephritis // J. Am. Soc. Nephrol. — 2016. — Vol. 27. — P. 2929-2939.
30. Rich S.A. De novo synthesis and secretion of a 36-kD protein by cells that form lupus inclusions in response to alpha-interferon // J. Clin. Invest. — 1995. — Vol. 95. — P. 219-226.
31. Rovin B.H., Zhang X. Biomarkers for lupus nephritis: the quest continues // Clin. J. Am. Soc. Nephrol. — 2009. — Vol. 4. — P. 1858-1865.
32. Rubinstein T., Pitashny M., Levine B., et al. Urinary neutrophil gelatinase-associated lipocalin as a novel biomarker for disease activity in lupus nephritis // Rheumatology (Oxford). — 2010. — Vol. 49. — P. 960-971.
33. Schwartz M.M., Kawala K.S., Corwin H.L., Lewis E.J. The prognosis of segmental glomerulonephritis in systemic lupus erythematosus // Kidney Int. — 1987. — Vol. 32. — P. 274-279.
34. Schwartz M.M., Korbet S.M., Lewis E.J., Collaborative Study Group. The prognosis and pathogenesis of severe lupus glomerulonephritis // Nephrol. Dial. Transplant. — 2008. — Vol. 23. — P. 1298-1306.
35. Schwartz M.M., Lan S.P., Bonsib S.M., et al. Clinical outcome of three discrete histologic patterns of injury in severe lupus glomerulonephritis // Am. J. Kidney Dis. — 1989. — Vol. 13. — P. 273-283.
36. Schwartz N., Rubinstein T., Burkly L.C., et al. Urinary TWEAK as a biomarker of lupus nephritis: a multicenter cohort study // Arthritis Res. Ther. — 2009. — Vol. 11 (5). — R143.
37. Seligman V.A., Lum R.F., Olson J.L., et al. Demographic differences in the development of lupus nephritis: a retrospective analysis // Am. J. Med. — 2002. — Vol. 112. — P. 726-729.
38. Sen D., Isenberg D.A. Antineutrophil cytoplasmic autoantibodies in systemic lupus erythematosus // Lupus. — 2003. — Vol. 12. — P. 651-658.
39. Wang F., Wang C.L., Tan C.T., Manivasagar M. Systemic lupus erythematosus in Malaysia: a study of 539 patients and comparison of prevalence and disease xpression in different racial and gender groups // Lupus. — 1997. — Vol. 6 (3). — P. 248-253.
40. Weening J.J., D’Agati V.D., Schwartz M.M., et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited // Kidney Int. — 2004. — Vol. 65 (2). — P. 521-530.
41. Yin Y., Wu X., Shan G., Zhang X. Diagnostic value of serum anti-C1q antibodies in patients with lupus nephritis: a meta-analysis // Lupus. — 2012. — Vol. 21 (10). — P. 1088-1097.
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