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Collapsing Glomerulopathy in 19 Patients with Systemic Lupus Erythematosus or Lupus-Like Disease
Clinical Journal of the American Society of Nephrology, 06/08/2012
Salvatore SP et al. – Collapsing glomerulopathy may be seen in Systemic Lupus Erythematosus patients presenting with massive proteinuria with or without lupus nephritis, which may have prognostic significance.
Methods- Clinicopathological features were retrospectively studied in 19 patients with SLE (16 patients) or SLE–like (3 patients) disease with collapsing glomerulopathy.
- Initially, 95% of patients had nephrotic syndrome with proteinuria of 3–12 g per 24 hours, creatinine levels of 0.6–9.6 mg/dl, positive lupus serologies, and normal complement levels in 63%.
- Segmental and/or global collapsing glomerulopathy was seen in 11%–77% of glomeruli.
- Tubular atrophy with focal microcystic changes and interstitial fibrosis was seen in 35% of patients.
- Tubular atrophy with focal microcystic changes and interstitial fibrosis was seen in 35% of patients.
- Initial treatment was with pulse/oral steroids.
- Follow–up from 13 patients revealed that 7 patients progressed to ESRD at the time of biopsy up to 21 months later, 1 patient returned to normal creatinine (1.1 mg/dl) without proteinuria, and 5 patients had creatinine of 1.2–3.6 mg/dl with proteinuria of 0.37–4 g per 24 hours.
