Clinical and Pathological Features of Pure Class Ⅴ Lupus Nephritis with Membranous Nephropathy_West China Medical Journal

Authors：

CHEN Xiaohan ,  HU Zhangxue

Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;

Corresponding author：

HU Zhangxue, Email: cher19@163.com

Keywords：

狼疮肾炎; 膜性肾病; 病理学; 肾活检

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

【摘要】　目的　发现提示早期Ⅴ型狼疮性肾炎（lupus nephritis，LN）的指标。　方法　 2004年 1月-2009年11月24例经肾活检诊断为Ⅴ型LN患者，与同期50例膜性肾病伴抗核抗体（antinuclear antibody，ANA）阳性患者、50例膜性肾病ANA阴性患者，以及13例膜性肾病ANA阳性且肾组织荧光为“满堂亮”患者的一般资料、肾病表现、肾脏病理以及实验室指标进行比较。　结果　 Ⅴ型LN与膜性肾病ANA阴性的患者相比，两组的性别、起病年龄、血红蛋白、补体水平、内皮和系膜增殖的比例等有明显差异。膜性肾病ANA阳性患者的临床和病理表现更接近于ANA阴性的膜性肾病，但其性别比仍以女性居多。而膜性肾病ANA阳性伴“满堂亮”的患者在性别、肾病表现、血红蛋白、补体水平等方面与Ⅴ型LN更为接近。　结论　膜性肾病ANA阳性患者具有异质性，其中肾脏病理表现为“满堂亮”的患者可能系早期Ⅴ型LN。
【Abstract】　Objective　 To find out the clinical and pathological characteristics of early pure class Ⅴ lupus nephritis (LN).　Methods　 A total of 24 patients with pure class Ⅴ LN diagnosed between January 2004 and November 2009 were included, and were compared with 50 antinuclear antibody (ANA)-positive patients with membranous nephropathy (MN) and 50 ANA-negative patients with MN. The clinical and pathological characteristics, laboratory test results were compared between the two groups. Then, 13 patients with "full house" fluorescence in renal biopsy specimens were chosen from the group of ANA-positive membranous nephropathy, whose clinical characteristics and laboratory test were compared with class Ⅴ LN patients.　Results　 There were significant differences in sex ratio, age, positive rate of hepatitis B surface antigen (HBsAg), levels of hemoglobin, white blood cell, platelet,complement, endothelial and mesangial proliferation between class Ⅴ LN and ANA-negative MN group. However, the sex ratio, levels of white blood cell, platelet were similar between class Ⅴ LN and ANA-positive MN group. The renal biopsy specimens in patients with ANA-positive MN with "full house" fluorescence were similar with those in the patients with class Ⅴ LN in sex ratio, renal injury, hemoglobin and complement and the positive rate of hepatitis B surface antigen.　Conclusion　 The demographic information and clinical manifestations in patients with class Ⅴ LN were similar to those in patients with ANA positive MN, especially in the patients wiht ANA-positive MN with "full house" fluorescence in renal biopsy specimens.

Citation： CHEN Xiaohan,HU Zhangxue. Clinical and Pathological Features of Pure Class Ⅴ Lupus Nephritis with Membranous Nephropathy. West China Medical Journal, 2011, 26(1): 22-25. doi: Copy

1.	Costenbader KH, Karlson EW, Mandl LA. Defining lupus cases for clinical studies: the Boston weighted criteria for the classification of systemic lupus erythematosus[J]. J Rheumatol, 2002, 29(12): 2545-2550.
2.	Weening JJ, D’Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited[J]. Kidney Int, 2004, 65(2): 521-530.
3.	Weening JJ, D’Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited[J]. J Am Soc Nephrol, 2004, 15(2): 241-250.
4.	Bombardier C, Gladman DD, Urowitz MB, et al. Derivation of the SLEDAI. A disease activity index for lupus patients. The committee on prognosis studies in SLE[J]. Arthritis Rheum, 1992, 35(6): 630-640.
5.	Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group[J]. Ann Intern Med, 1999, 130(6): 461-470.
6.	全国eGFR课题协作组. MDRD方程在我国慢性肾脏病患者中的改良和评估[J]. 中华肾脏病杂志, 2006: 22(10): 589-595.
7.	陈强, 胡伟新, 刘志红, 等. 152例V型狼疮肾炎的临床病理研究[J]. 中华肾脏病杂志, 2002, 18(6): 417-421.
8.	Adu D, Williams DG, Taube D, et al. Late onset systemic lupus erythematosus and lupus-like disease in patients with apparent idiopathic glomerulonephritis[J]. Q J Med, 1983, 52(208): 471-487.

1. 　Costenbader KH, Karlson EW, Mandl LA. Defining lupus cases for clinical studies: the Boston weighted criteria for the classification of systemic lupus erythematosus[J]. J Rheumatol, 2002, 29(12): 2545-2550.
2. 　Weening JJ, D’Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited[J]. Kidney Int, 2004, 65(2): 521-530.
3. 　Weening JJ, D’Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited[J]. J Am Soc Nephrol, 2004, 15(2): 241-250.
4. 　Bombardier C, Gladman DD, Urowitz MB, et al. Derivation of the SLEDAI. A disease activity index for lupus patients. The committee on prognosis studies in SLE[J]. Arthritis Rheum, 1992, 35(6): 630-640.
5. 　Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group[J]. Ann Intern Med, 1999, 130(6): 461-470.
6. 　全国eGFR课题协作组. MDRD方程在我国慢性肾脏病患者中的改良和评估[J]. 中华肾脏病杂志, 2006: 22(10): 589-595.
7. 　陈强, 胡伟新, 刘志红, 等. 152例V型狼疮肾炎的临床病理研究[J]. 中华肾脏病杂志, 2002, 18(6): 417-421.
8. 　Adu D, Williams DG, Taube D, et al. Late onset systemic lupus erythematosus and lupus-like disease in patients with apparent idiopathic glomerulonephritis[J]. Q J Med, 1983, 52(208): 471-487.

West China Medical Journal

Clinical and Pathological Features of Pure Class Ⅴ Lupus Nephritis with Membranous Nephropathy

Abstract Full text Figures/Tables Video References Cited by

Format

Content