TẠP CHÍ SỐ 9-TV NĂM 2018

A survey on manifestations, laboratory findings and pathological renal biopsy-based classification of patients with lupus nephritis

Bui Van Khanh; Nguyen Van Doan; Nguyen Dang Dung

Tóm tắt

Introduction: Lupus nephritis comprises a spectrum of glomerular, vascular, and tubulointerstitial lesions, which has significant racial variations in severity and manifestations. The current International Society of Nephrology/Renal Pathology Society classification (2003) has been successfully improved for the categorization of lupus glomerulonephritis. Methods: This study is a retrospective analysis on clinical manifestations and the pathological features of lupus nephritis. Clinical manifestations and laboratory test were collected and analysed by SPSS 20.0 program. Results: Among the 38 patients with lupus nephritis, 92.1% was female, with the major manifestations being hypertension (47.4%), edema (44.7%), skin malar rash (36.9%), arthritis (57.9%), anemia (81.1%), oral ulcer (21.1%). The mean SLEDAI was 20.58 ± 6.46, and mean serum level of creatinine was 152.86 ± 125.96 µmol/L. Percentage of patients with hypoalbuminemia was 75%. Of the patients involved, 94.4% showed with decrease of C3 complement, 69.4% of C4 complement. The mean 24-hour urine protein was 5.03 ± 4.88 g. 94.4% of the patients had ANA test positive, among which 69.4% positive with anti-dsDNA, and 14.3% positive with anti-Sm autoantibodies. On the basis of this classification, 38 patients with lupus nephritis revealed the following distribution: Class I: 0%; class II: 5.3%; class III: 50%; class IV: 28.9%; class V: 10.5%; combined classes III & IV: 2.6%; and class VI: 2.6%. Conclusions: In patients with lupus nephritis, manifestations and laboratory findings by renal biopsy were clinically valuable in identifying different renal classifications of lupus pathology, which was helpful for diagnosis and treatment guide. * Keywords: Lupus nephritis; Clinical Manifestation; Laboratory finding.

Abstract

Introduction: Lupus nephritis comprises a spectrum of glomerular, vascular, and tubulointerstitial lesions, which has significant racial variations in severity and manifestations. The current International Society of Nephrology/Renal Pathology Society classification (2003) has been successfully improved for the categorization of lupus glomerulonephritis. Methods: This study is a retrospective analysis on clinical manifestations and the pathological features of lupus nephritis. Clinical manifestations and laboratory test were collected and analysed by SPSS 20.0 program. Results: Among the 38 patients with lupus nephritis, 92.1% was female, with the major manifestations being hypertension (47.4%), edema (44.7%), skin malar rash (36.9%), arthritis (57.9%), anemia (81.1%), oral ulcer (21.1%). The mean SLEDAI was 20.58 ± 6.46, and mean serum level of creatinine was 152.86 ± 125.96 µmol/L. Percentage of patients with hypoalbuminemia was 75%. Of the patients involved, 94.4% showed with decrease of C3 complement, 69.4% of C4 complement. The mean 24-hour urine protein was 5.03 ± 4.88 g. 94.4% of the patients had ANA test positive, among which 69.4% positive with anti-dsDNA, and 14.3% positive with anti-Sm autoantibodies. On the basis of this classification, 38 patients with lupus nephritis revealed the following distribution: Class I: 0%; class II: 5.3%; class III: 50%; class IV: 28.9%; class V: 10.5%; combined classes III & IV: 2.6%; and class VI: 2.6%. Conclusions: In patients with lupus nephritis, manifestations and laboratory findings by renal biopsy were clinically valuable in identifying different renal classifications of lupus pathology, which was helpful for diagnosis and treatment guide. * Keywords: Lupus nephritis; Clinical Manifestation; Laboratory finding.

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