| Renal involvement in systemic lupus erythematosus. A study of 180 patients from a single center. | |
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MedLine Citation:
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PMID: 10352647 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Charts of 180 patients (147 women, 33 men) with systemic lupus erythematosus (SLE) complicated by renal involvement were retrospectively analyzed from a series of 436 patients. Mean age at renal disease onset was 27 years. Thirty-six percent of the patients had renal involvement after diagnosis of lupus, for 30.7% of that group it was more than 5 years later. Renal involvement occurred more frequently in young male patients of non-French non-white origin. Patients with renal involvement suffered more commonly from malar rash, psychosis, myocarditis, pericarditis, lymphadenopathy, and hypertension. Anemia, low serum complement, and raised anti-dsDNA antibodies were more frequent. According to the 1982 World Health Organization classification, histologic examination of initial renal biopsy specimen in 158 patients showed normal kidney in 1.5% of cases, mesangial in 22%, focal proliferative in 22%, diffuse proliferative in 27%, membranous in 20%, chronic sclerosing glomerulonephritis in 1%, and other forms of nephritis in 6.5%. Distribution of initial glomerulonephritis patterns was similar whether renal involvement occurred before or after the diagnosis of lupus. Transformation from 1 histologic pattern to another was observed in more than half of the analyzable patients (those who underwent at least 2 renal biopsies). Nephritis evolved toward end-stage renal disease in 14 patients despite the combined use of steroids and cyclophosphamide in 12. Initial elevated serum creatinine levels, initial hypertension, non-French non-white origin, and proliferative lesions on the initial renal biopsy were indicators of poor renal outcome. Twenty-four patients died after a mean follow-up of 109 months from SLE diagnosis. Among our 436 patients, the 10-year survival rate was not significantly affected by the presence or absence of renal involvement at diagnosis (89% and 92%, respectively). |
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Authors:
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D L Huong; T Papo; H Beaufils; B Wechsler; O Blétry; A Baumelou; P Godeau; J C Piette |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Medicine Volume: 78 ISSN: 0025-7974 ISO Abbreviation: Medicine (Baltimore) Publication Date: 1999 May |
Date Detail:
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Created Date: 1999-06-17 Completed Date: 1999-06-17 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 2985248R Medline TA: Medicine (Baltimore) Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 148-66 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Age of Onset Anti-Inflammatory Agents / therapeutic use Biopsy Cause of Death Child Creatinine / blood Female Follow-Up Studies Humans Immunosuppressive Agents / therapeutic use Kidney Failure, Chronic / etiology Lupus Nephritis* / metabolism, mortality, pathology, therapy Male Middle Aged Predictive Value of Tests Prednisone / therapeutic use Prevalence Proteinuria / etiology Retrospective Studies Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Immunosuppressive Agents; 53-03-2/Prednisone; 60-27-5/Creatinine |
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