Lupus Nephritis in Iran
MR Nejati, M Asgari, S Ossareh, M Momeni, M Mojarrad. Hasheminejad Kidney Center, Tehran, Islamic Republic of Iran
Background: Renal involvement is one of the most serious complications of systemic lupus erythematousus (SLE) and the prevalence of Lupus nephritis is reported to be 40-75% of patients in different studies. Moreover, there have been differences in the severity of clinical and the prevalence of pathological findings in different geographical regions. However, our data concerning Iranian patients are rare.
Design: In this study, we reviewed known cases of SLE, according to American college of Rheumatology, who were admitted to Hasheminejad Kidney Center from 1998 to 2007 and underwent a kidney biopsy. After verifying the diagnoses based on clinicopathological findings, 153 cases met the entry criteria. All the patients' biopsies were reviewed by a single nephropathologist and were classified according to WHO classification. Also, clinical and laboratorial findings of the patients were evaluated.
Results: A total of 153 patients (125 female, 28 male) were the subjects of this study having an average age of 29.3±11.4 (range 12-71 years).The most common clinical manifestations were arthritis, hypertension and malar rash (80, 52.3, 45.2% respectively).The prevalence of major renal syndromes including nephrotic and nephritic syndromes were 55% and 23.5 %, respectively. The mean level of serum creatinin was 2.26 mg/dl and 48.4% had high serum creatinin (1.5 mg/dl). Anemia (Hb<12gr/dl), Thrombocytopenia (Plt. <100000/l) and leukopenia(WBC<4000/l) were detected in 80%, 13.3% and 22.2% of patients, respectively. Low serum C3, C4 and CH50 were found in 63.4, 54.9 and 55.6 %, respectively. Patients with Class IV lupus Nephritis had the most frequency of hypertension (53%), low C3 (56%) and a high level of creatinin (54%). Antinuclear antibody was found to be 81% and anti-ds DNA antibody was detected in 53.1% of cases. 5.7 % of patients were ANCA positive. Histopathologic classification of the patients according to WHO criteria were as follows: class II 9.9%, class III 27%, class IV 55.3%, class V 7.8%.
Conclusions: Our study supports the correlation between some of the clinical and laboratorial findings of the patients with the histopathologic classification. The most common histopathologic class of our study was class IV (diffuse lupus nephritis) that was similar to other reports from France, USA, Netherlands and Thailand. We also compared our findings with other studies in Middle East and to our surprise we found that, unlike our study, the most frequent lupus nephritis class in studies from United Arab Emirates, Saudi Arabia and Kuwait was Class III.
Category: Kidney (does not include tumors)
Wednesday, March 24, 2010 1:00 PM
Poster Session VI # 241, Wednesday Afternoon