Spectrum of Kidney Involvement in Patients with Myelodysplastic Syndromes.

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_95B38036CCD6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Spectrum of Kidney Involvement in Patients with Myelodysplastic Syndromes.
Journal
Kidney international reports
Author(s)
Schwotzer N., Provot F., Ville S., Daniel L., Le Fur A., Kissling S., Jourde-Chiche N., Karras A., Moreau A., Augusto J.F., Gnemmi V., Perrochia H., Bataille S., Le Quintrec M., Goujon J.M., Rotman S., Fakhouri F.
ISSN
2468-0249 (Electronic)
ISSN-L
2468-0249
Publication state
Published
Issued date
03/2021
Peer-reviewed
Oui
Volume
6
Number
3
Pages
746-754
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Myelodysplastic syndromes (MDS) are characterized by a high prevalence of associated autoimmune manifestations. Kidney involvement has been rarely reported in MDS patients. We report on the spectrum of kidney pathological findings in MDS patients.
We retrospectively identified MDS patients who had undergone a kidney biopsy between 2001 and 2019 in nine Swiss and French nephrology centres.
Nineteen patients (median age 74 years [63-83]) were included. At the time of kidney biopsy, eleven (58%) patients had extra-renal auto-immune manifestations and sixteen (84%) presented with acute kidney injury. Median serum creatinine at diagnosis was 2.8 mg/dL [0.6-8.3] and median urinary protein to creatinine ratio was 1.2 g/g [0.2-11]. Acute tubulo-interstitial nephritis (TIN) was present in seven (37%) patients. Immunofluorescence study in one patient with acute TIN disclosed intense IgG deposits along the tubular basement membrane and Bowman's capsule. Other kidney pathological features included ANCA-negative pauci-immune necrotizing and crescentic glomerulonephritis (n = 3), membranous nephropathy (n = 2), IgA nephropathy (n = 1), IgA vasculitis (n = 1), immunoglobulin-associated membrano-proliferative glomerulonephritis type I (n=1), crescentic C3 glomerulopathy (n = 1), fibrillary glomerulonephritis (n = 1) and minimal change disease (n = 1). Eleven (58%) patients received immunosuppressive treatments, among whom one developed a severe infectious complication. After a median follow-up of 7 month [1-96], nine (47%) patients had chronic kidney disease stage 3 (n = 6) or 4 (n = 3) and five (26%) progressed to end-stage kidney disease. Three patients died.
MDS are associated to several autoimmune kidney manifestations, predominantly acute TIN. MDS are to be listed among the potential causes of autoimmune TIN.
Keywords
acute tubulointerstitial nephritis, autoimmunity, myelodysplastic syndromes
Pubmed
Web of science
Open Access
Yes
Create date
19/03/2021 13:58
Last modification date
06/08/2021 7:11
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