Immunohistochemical detection of intravascular platelet microthrombi in patients with lupus nephritis and anti-phospholipid antibodies
Galindo M et al. - Study demonstrates that immunodetection of intravascular CD61+ platelet aggregates is more sensitive than histological evaluation to detect acute microthrombosis and provides a better correlation with anti-phospholipid syndrome (aPLs) in systemic lupus erythematosus (SLE) patients. In contrast, histological lesions consistent with APS nephropathy were not associated with aPLs but with cardiovascular risk factors and worse renal outcome. Methods- An evaluation of whether:
- use of platelet IHC markers improves the sensitivity of histological methods to detect microthrombosis in SLE nephritis and aPLs and
- to analyse the clinicopathological correlations of microthrombosis in this setting
- Kidney biopsy specimens from 65 pts, including 36 with positive aPLs, were studied by IHC using Abs against platelet glycoproteins CD41 and CD61
- Clinical data at the time of kidney biopsy and during a mean f/u of 7.5 yrs after biopsy were recorded and analysed with regard to histological or IHC data
Results- Histological lesions previously defined as APS nephropathy were found in 33% of the SLE kidney biopsies
- They were not associated with positive aPLs
- Microthrombi detected as intravascular CD61+ platelet deposits were present in 43% of the tissues
- They were associated with positive aPLs, but not with histological APS nephropathy, nephritis manifestations nor with renal outcome
- Histological APS lesions but not CD61+ microthrombi correlated with an older age at nephritis presentation, previous CV risk factors and worse renal outcome
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