Nephrology Medical News about glomerular microthrombosis;lupus nephritis;antiphospholipid antibody profiles

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Antiphospholipid antibody profiles in lupus nephritis with glomerular microthrombosis: A prospective study of 124 cases
Arthritis Research & Therapy, 06/24/09

Zheng H et al. – Study reports that glomerular microthrombosis (GMT) occurs in approximately 20.2% of lupus nephritis (LN) patients. Patients with GMT have severer renal tissue injuries and poorer renal functions than patients without GMT. The lupus anticoagulant and antibodies against β2 glycoprotein I and thrombin may play a role in GMT.

Methods

An investigation of the prevalence of GMT in LN pts and to examine the relationship between the aPL profiles and GMT
Renal biopsy specimens were examined for the presence of glomerular microthrombi
Plasma samples from 25 LN pts with GMT (LN-GMT group) and 99 LN pts w/o GMT (LN-non-GMT group) were tested for:
- lupus anticoagulant and Abs against cardiolipin,
- β2 glycoprotein I, plasmin, thrombin, tissue plasminogen activator, and annexin II

Results

Prevalence of GMT in LN pts was 20.2%
Compared with the LN-non-GMT group, the LN-GMT group had:
- Elevated SLE disease activity index
- Elevated renal tissue injury activity and chronicity indices
- Elevated serum creatinine, blood urea nitrogen, and proteinuria levels
- Lower serum C3 level and much intense glomerular C3, C1q staining, and
- Higher frequency of hypertension
Additionally, the detection rate of lupus anticoagulant, IgG anti-β2 glycoprotein I and anti-thrombin Abs were higher in the LN-GMT vs LN-non-GMT group
No differences in the detection rates of IgG anti-cardiolipin, plasmin, tissue plasminogen activator (t-PA), or annexin II Abs
No detectable difference in IgM Abs to the above antigens was observed between the 2 groups