The expanding spectrum of renal diseases associated with antiphospholipid syndrome
Details
Serval ID
serval:BIB_CDD31269C823
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The expanding spectrum of renal diseases associated with antiphospholipid syndrome
Journal
Am J Kidney Dis
ISSN
1523-6838 (Electronic)
ISSN-L
0272-6386
Publication state
Published
Issued date
06/2003
Volume
41
Number
6
Pages
1205-11
Language
english
Notes
Fakhouri, Fadi
Noel, Laure-Helene
Zuber, Julien
Beaufils, Helene
Martinez, Frank
Lebon, Pierre
Papo, Thomas
Chauveau, Dominique
Bletry, Olivier
Grunfeld, Jean-Pierre
Piette, Jean-Charles
Lesavre, Philippe
eng
Multicenter Study
Review
Am J Kidney Dis. 2003 Jun;41(6):1205-11. doi: 10.1016/s0272-6386(03)00352-4.
Noel, Laure-Helene
Zuber, Julien
Beaufils, Helene
Martinez, Frank
Lebon, Pierre
Papo, Thomas
Chauveau, Dominique
Bletry, Olivier
Grunfeld, Jean-Pierre
Piette, Jean-Charles
Lesavre, Philippe
eng
Multicenter Study
Review
Am J Kidney Dis. 2003 Jun;41(6):1205-11. doi: 10.1016/s0272-6386(03)00352-4.
Abstract
BACKGROUND: The association of thrombotic events and/or pregnancy complications with circulating antiphospholipid antibodies defines antiphospholipid syndrome (APS). In previous reports, renal involvement in APS consisted mainly of thrombotic vascular complications involving large vessels or intrarenal small-sized vessels (APS nephropathy). We report 9 cases of glomerulonephritis associated with APS. These cases are characterized by predominant pathological features distinct from vascular APS nephropathy. METHODS: We reviewed consecutive renal biopsies examined in 2 French university hospitals between 1980 and 2002 and identified renal biopsies performed in patients with primary APS. RESULTS: We identified 29 biopsies performed in patients with APS. Twenty biopsies showed characteristic features of APS nephropathy. In 9 cases, predominant pathological features distinct from vascular APS nephropathy were noted: membranous nephropathy (3 cases), minimal change disease/focal segmental glomerulosclerosis (3 cases), mesangial C3 nephropathy (2 cases), and pauci-immune crescentic glomerulonephritis (1 case). In 7 cases, the presentation of renal symptoms was subacute or chronic. Two patients experienced episodes of acute renal failure. At referral, median creatinine clearance was 50 mL/min (0.83 mL/s) (range, 18 to 117 mL/min [0.30 to 1.95 mL/s]). Proteinuria was noted in all cases (range, 1.5 to 15 g/d), with nephrotic syndrome in 4 cases. Lupus anticoagulant was present in all cases, and anticardiolipin antibodies, in 8 cases. Anti-DNA antibodies repeatedly were negative in all cases. Treatment consisted of antihypertensive therapy (6 cases), anticoagulant drugs (5 cases), steroids (4 cases), and antiplatelet drugs (3 cases). At last follow-up, renal function remained stable in 7 patients. Of 2 patients presenting with acute renal failure, 1 patient recovered normal renal function, whereas the other patient progressed to end-stage renal failure. CONCLUSION: The cases reported here represent a new aspect of the expanding spectrum of renal diseases encountered in association with APS.
Keywords
Adrenal Cortex Hormones/therapeutic use, Adult, Aged, Anticoagulants/therapeutic use, Antihypertensive Agents/therapeutic use, Antiphospholipid Syndrome/blood/*complications/drug therapy, Autoantibodies/analysis, Autoimmune Diseases/blood/*complications/drug therapy, Biopsy, Blood Proteins/analysis, Female, France/epidemiology, Glomerulonephritis/epidemiology/etiology, Glomerulonephritis, Membranoproliferative/epidemiology/etiology, Glomerulonephritis, Membranous/epidemiology/etiology, Glomerulosclerosis, Focal Segmental/epidemiology/etiology, Humans, Hypertension/drug therapy/etiology, Kidney/pathology, Kidney Diseases/drug therapy/epidemiology/*etiology, Kidney Failure, Chronic/epidemiology/etiology, Male, Nephrosis, Lipoid/epidemiology/etiology, Nephrotic Syndrome/epidemiology/etiology, Platelet Aggregation Inhibitors/therapeutic use, Retrospective Studies, Thrombophilia/drug therapy/etiology
Pubmed
Create date
01/03/2022 11:18
Last modification date
02/03/2022 7:36