A study on clinical and pathologic features in lupus nephritis with mainly IgA deposits and a literature review.

Clinical & Developmental Immunology Pub Date : 2013-01-01 Epub Date: 2013-09-24 DOI:10.1155/2013/289316
Liu Hongyan, Zheng Yi, Dong Bao, Lu Yuewu, Meng Juan
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引用次数: 10

Abstract

Objective: To study the clinical and pathologic features of systemic lupus erythematosus (SLE) that has atypical lupus nephritis (LN) with mainly IgA deposits.

Methods: We searched the SLE patients who had nephritis with mainly IgA deposits in our hospital and selected the information including clinical manifestations, laboratory tests, treatments, and prognosis.

Results: From January 2009 to June 2012, 5 patients were definitely diagnosed as SLE according to both 1982 and 2009 ACR classification criteria. But renal biopsy showed that all cases had mainly IgA deposits and were free of IgG, C1q, and fibrinogen-related antigen deposits under immunofluorescent microscopy, which did not match with typical LN. There were 2 males and 3 females, aging from 31 to 64 years and with an average of (42.20 ± 13.59) years. The 5 cases had multiple-system involvements, mainly the renal system. Compared to primary IgAN, the atypical LN showed some differences: older than primary IgAN, more women than men, no previous infection history, lower incidence of serum IgA elevation, and ACL positive rate as high as 100%.

Conclusion: Nephritis with mainly IgAN deposits, as an atypical LN, may be a special subtype of SLE.

Abstract Image

以IgA沉积为主的狼疮性肾炎临床病理特征的研究及文献复习。
目的:探讨以IgA沉积为主的不典型狼疮性肾炎(LN)合并系统性红斑狼疮(SLE)的临床及病理特点。方法:检索我院以IgA沉积为主的SLE肾炎患者,选取临床表现、实验室检查、治疗、预后等信息。结果:2009年1月至2012年6月,5例患者均按照1982年和2009年ACR分级标准确诊为SLE。但肾活检显示,所有病例均以IgA沉积为主,免疫荧光显微镜下均无IgG、C1q、纤维蛋白原相关抗原沉积,与典型LN不匹配。男性2例,女性3例,年龄31 ~ 64岁,平均(42.20±13.59)岁。5例多系统受累,以肾系统为主。与原发性IgAN相比,非典型LN表现出一些差异:年龄大于原发性IgAN,女性多于男性,无感染史,血清IgA升高发生率较低,ACL阳性率高达100%。结论:以IgAN沉积为主的肾炎作为一种非典型LN,可能是SLE的一种特殊亚型。
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