Thrombotic microangiopathy in membranous lupus nephritis
Keywords:
Thrombotic microangiopathy, membranous lupus nephritis, SLEAbstract
Renal vascular lesions in SLE are grouped into uncomplicated vascular immune deposits, non-inflammatory necrotizing vasculopathy, thrombotic microangiopathy (TMA) and renal vasculitis. Thrombotic microangiopathy (TMA) is a rare finding in patients with SLE and is associated with poor prognosis. Treatment approach for TMA with membranous nephritis is highly challenging. The present case study discusses the case of a young woman with SLE and membranous lupus nephritis, complicated by TMA.
References
Banfi G, Bertani T, Boeri V, Faraggiana T, Mazzucco G, Monga G, et al. Renal vascular lesions as a marker of poor prognosis in patients with lupus nephritis. Gruppo Italiano per lo Studio della Nefrite Lupica (GISNEL). Am J Kidney Dis. 1991 Aug;18(2):240–8.
Grishman E, Venkataseshan VS. Vascular lesions in lupus nephritis. Mod Pathol. 1988 May;1(3):235–41.
Devinsky O, Petito CK, Alonso DR. Clinical and neuropathological findings in systemic lupus erythematosus: the role of vasculitis, heart emboli, and thrombotic thrombocytopenic purpura. Ann Neurol. 1988 Apr;23(4):380–4.
Appel GB, Pirani CL, D’Agati V. Renal vascular complications of systemic lupus erythematosus. J Am Soc Nephrol. 1994 Feb;4(8):1499–515.
Farrugia E, Torres VE, Gastineau D, Michet CJ, Holley KE. Lupus anticoagulant in systemic lupus erythematosus: a clinical and renal pathological study. Am J Kidney Dis. 1992 Nov;20(5):463–71.
Kincaid-Smith P, Fairley KF, Kloss M. Lupus anticoagulant associated with renal thrombotic microangiopathy and pregnancy-related renal failure. Q J Med. 1988 Oct;68(258):795–815.
Nesher G, Hanna VE, Moore TL, Hersh M, Osborn TG. Thrombotic microangiographic hemolytic anemia in systemic lupus erythematosus. Semin Arthritis Rheum. 1994 Dec;24(3):165–72.
D’Agati V, Kunis C, Williams G, Appel GB. Anti-cardiolipin antibody and renal disease: a report three cases. J Am Soc Nephrol. 1990 Nov;1(5):777–84.
Piette JC, Cacoub P, Wechsler B. Renal manifestations of the antiphospholipid syndrome. Semin Arthritis Rheum. 1994 Jun;23(6):357–66.
Jennette JC, Heptinstall RH. Heptinstall’s pathology of the kidney. 6th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2007.
Daugas E, Nochy D, Huong DLT, Duhaut P, Beaufils H, Caudwell V, et al. Antiphospholipid syndrome nephropathy in systemic lupus erythematosus. J Am Soc Nephrol. 2002 Jan;13(1):42–52.
Chen M-H, Chen M-H, Chen W-S, Mu-Hsin Chang P, Lee H-T, Lin H-Y, et al. Thrombotic microangiopathy in systemic lupus erythematosus: a cohort study in North Taiwan. Rheumatology (Oxford). 2011 Apr;50(4):768–75.
Bell WR, Braine HG, Ness PM, Kickler TS. Improved Survival in Thrombotic Thrombocytopenic Purpura–Hemolytic Uremic Syndrome. New England Journal of Medicine. 1991 Aug 8;325(6):398–403
