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6 Cards in this Set
- Front
- Back
- 3rd side (hint)
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How does renal disease in patients with SLE usually manifest?
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immune complex-mediated glomerulonephritis (GN)
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Renal disease in patients who have SLE usually manifests as an immune complex-mediated glomerulonephritis (GN), often associated with hypocomplementemia and positive serologic testing for antinuclear antibody (ANA) and anti-double-stranded (ds) DNA. A recent observational study from Toronto demonstrated that 37% of children have nephritis at diagnosis, 46% within 1 year of diagnosis, and 55% in long-term follow-up
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What are the clinical manifestations of lupus nephritis
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Those typically seen with GN and may include hematuria, proteinuria, azotemia, hypertension and edema.
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How is lupus nephritis categorize by the WHO?
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Class I (normal)
Class II (mesangial proliferative GN) Class III (focal proliferative GN) Class IV (diffuse proliferative GN) Class V (membranous GN) |
The clinical manifestations of lupus nephritis are those typically seen with GN and may include one or more of the following: hematuria, proteinuria, azotemia, hypertension, and edema. Lupus nephritis is categorized further by histologic criteria into the World Health Organization classification system: class I (normal), class II (mesangial proliferative GN), class III (focal proliferative GN), class IV (diffuse proliferative GN), and class V (membranous GN). Because of the need to classify the form of nephritis prior to the institution of corticosteroids, the standard of care is to obtain a renal biopsy prior to treatment. Some forms of lupus nephritis, including diffuse proliferative nephritis, are treated with cyclophosphamide as an adjunctive agent, but this medication should not be used for renal indications without a kidney biopsy. Results of the renal biopsy can provide both prognostic and treatment information.
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What is the standard of care to diagnose nephritis in lupus?
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Renal biopsy which can provide both prognostic and treatment information.
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How is renal disease monitored in lupus?
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Periodic assessment of urinary protein excretion as well as measurement of serologic markers such as complement components and anti-ds DNA titers.
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What are the risk factors (4) for permanent renal damage from HSP?
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1) age > 7 years
2) purpura lasting > 1 month 3) severe, persistent GI symptoms 4) decreased Factor XIII |
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