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The spectrum of renal diseases with lupus-like features: a single-center study
BACKGROUND: A subset of patients without overt systemic lupus erythematosus (SLE) present with biopsy findings typically seen in lupus nephritis (LN). Although a minority eventually develops SLE, many do not. It remains unclear how to classify or treat these patients. Our study attempted to further...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8979540/ https://www.ncbi.nlm.nih.gov/pubmed/35357272 http://dx.doi.org/10.1080/0886022X.2022.2057862 |
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author | Ahmed, Maliha Love, Tanzy Moore, Catherine Le, Thu H. Jean-Gilles, Jerome Goldman, Bruce Choung, Hae Yoon Grace |
author_facet | Ahmed, Maliha Love, Tanzy Moore, Catherine Le, Thu H. Jean-Gilles, Jerome Goldman, Bruce Choung, Hae Yoon Grace |
author_sort | Ahmed, Maliha |
collection | PubMed |
description | BACKGROUND: A subset of patients without overt systemic lupus erythematosus (SLE) present with biopsy findings typically seen in lupus nephritis (LN). Although a minority eventually develops SLE, many do not. It remains unclear how to classify or treat these patients. Our study attempted to further understand the clinical and pathological characteristics of cases with lupus-like nephritis (LLN). METHODS: Among 2700 native kidney biopsies interpreted at University of Rochester Medical Center (URMC) from 2010 to 2019, we identified 27 patients with biopsies showing lupus-like features (LL-fx) and 96 with LN. Of those with LL-fx, 17 were idiopathic LLN and 10 were associated with a secondary etiology (e.g., infection/drugs). RESULTS: At the time of biopsy, the LLN-group tended to be slightly older (44 vs. 35), male (58.8 vs. 17.7%, p = .041), and Caucasian (47.0 vs. 28.1%, p = .005). Chronic kidney disease was the most common biopsy indication in LLN (21.4 vs. 2.8%, p = .001). Both LN and LLN presented with nephrotic-range proteinuria (mean 5.73 vs. 4.40 g/d), and elevated serum creatinine (mean 1.66 vs. 1.47 mg/dL). Tubuloreticular inclusions (TRIs; p < .001) and fibrous crescents (p = .04) were more often seen in LN, while more tubulointerstitial scarring was seen in LLN (p = .011). At mean follow-up of 1684 d (range: 31–4323), none of the LLN patients developed ESRD. A subset of both LN and cases with LL-fx overlapped with other autoimmune diseases. CONCLUSIONS: Lupus-like pathologic features are seen in a wide array of disease processes. The findings suggest that LLN may be a manifestation of an autoimmune process that overlaps with SLE. |
format | Online Article Text |
id | pubmed-8979540 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-89795402022-04-05 The spectrum of renal diseases with lupus-like features: a single-center study Ahmed, Maliha Love, Tanzy Moore, Catherine Le, Thu H. Jean-Gilles, Jerome Goldman, Bruce Choung, Hae Yoon Grace Ren Fail Clinical Study BACKGROUND: A subset of patients without overt systemic lupus erythematosus (SLE) present with biopsy findings typically seen in lupus nephritis (LN). Although a minority eventually develops SLE, many do not. It remains unclear how to classify or treat these patients. Our study attempted to further understand the clinical and pathological characteristics of cases with lupus-like nephritis (LLN). METHODS: Among 2700 native kidney biopsies interpreted at University of Rochester Medical Center (URMC) from 2010 to 2019, we identified 27 patients with biopsies showing lupus-like features (LL-fx) and 96 with LN. Of those with LL-fx, 17 were idiopathic LLN and 10 were associated with a secondary etiology (e.g., infection/drugs). RESULTS: At the time of biopsy, the LLN-group tended to be slightly older (44 vs. 35), male (58.8 vs. 17.7%, p = .041), and Caucasian (47.0 vs. 28.1%, p = .005). Chronic kidney disease was the most common biopsy indication in LLN (21.4 vs. 2.8%, p = .001). Both LN and LLN presented with nephrotic-range proteinuria (mean 5.73 vs. 4.40 g/d), and elevated serum creatinine (mean 1.66 vs. 1.47 mg/dL). Tubuloreticular inclusions (TRIs; p < .001) and fibrous crescents (p = .04) were more often seen in LN, while more tubulointerstitial scarring was seen in LLN (p = .011). At mean follow-up of 1684 d (range: 31–4323), none of the LLN patients developed ESRD. A subset of both LN and cases with LL-fx overlapped with other autoimmune diseases. CONCLUSIONS: Lupus-like pathologic features are seen in a wide array of disease processes. The findings suggest that LLN may be a manifestation of an autoimmune process that overlaps with SLE. Taylor & Francis 2022-03-31 /pmc/articles/PMC8979540/ /pubmed/35357272 http://dx.doi.org/10.1080/0886022X.2022.2057862 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Ahmed, Maliha Love, Tanzy Moore, Catherine Le, Thu H. Jean-Gilles, Jerome Goldman, Bruce Choung, Hae Yoon Grace The spectrum of renal diseases with lupus-like features: a single-center study |
title | The spectrum of renal diseases with lupus-like features: a single-center study |
title_full | The spectrum of renal diseases with lupus-like features: a single-center study |
title_fullStr | The spectrum of renal diseases with lupus-like features: a single-center study |
title_full_unstemmed | The spectrum of renal diseases with lupus-like features: a single-center study |
title_short | The spectrum of renal diseases with lupus-like features: a single-center study |
title_sort | spectrum of renal diseases with lupus-like features: a single-center study |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8979540/ https://www.ncbi.nlm.nih.gov/pubmed/35357272 http://dx.doi.org/10.1080/0886022X.2022.2057862 |
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