LUPUS NEPHRITIS-A CRITICAL ANALYSIS OF 17 PATIENTS |
| |
Authors: | PK PRASHER PP VARMA KV BALIGA SS UPPAL JS SAINI VSM |
| |
Affiliation: | *Classified Specialist (Med & Nephrology), Command Hospital (Western Command), Chandimandhir;+Classified Specialist (Med & Nephrology), Command Hospital (Southern Command), Pune;#Classified Specialist (Med & Nephrology), Command Hospital (Eastern Command), Calcutta;**Classified Specialist (Med & Immunology), Command Hospital (Eastern Command), Calcutta;++DDMS, HQ 11 Corps (Med), c/o 56 APO |
| |
Abstract: | Over a 3 year period from June 94 to June 97, out of 28 patients of systemic lupus, 17 were diagnosed as renal lupus. Demographic data showed 12 females and 5 males, mean age being 32.2 years (range 12 to 54 years). Mean time gap between presentation and definitive diagnosis was 32.4 days (7 days to 5 years). 2 patients (11.76%) presented renal lupus, one (5.88%) with acute interstitial lung disease and the remaining had the usual systemic manifestations of lupus. Anti dsDNA antibodies were positive in all patients while ANA was negative in 3 cases. Renal involvement consisted of rapidly progressive glomerulonephritis in 2 patients (11.76%), nephrotic syndrome in 4 (23.52%) and non nephrotic range proteinuria in 11 (64.70%) patients. Mean serum creatinine at presentation was 2.4mg/dl (0.8mg/dl to 8.9 mg/dl). Three patients were dialysis dependent. Renal histology on light microscopy comprised of class II lesions in one (5.88%), class III in 4 (23.52%), class IV in 11 (64.70%-including one with crescents) and class V in one (5.88%) patient. All patients with advanced class III/IV lesions were treated with corticosteroids and cyclophosphamide pulses. Except one patient who died of pyopericardium all others improved and their serum creatinine stabilised around 2.3 mg/dl (0.8 to 4.6 mg/dl). The study highlights the importance of early diagnosis and aggressive management in this potentially treatable disease.KEY WORDS: Lupus nephritis, Pulse cyclophosphamide |
| |
Keywords: | Lupus nephritis Pulse cyclophosphamide |
本文献已被 ScienceDirect 等数据库收录! |
|