Abstract: FR-PO733

Full House Immunofluorescence Nephropathy in Patients with Negative Clinicopathological Spectrum for Systemic Lupus Erythematosus

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Flores fonseca, Milagros Melissa, Centro Medico Nacional de Occidente (CMNO). Instituto Mexicano de Seguridad Social (IMSS), Guadalajara, Jalisco, Mexico
  • Villanueva-Perez, Arisbeth, Centro Medico Nacional de Occidente (CMNO). Instituto Mexicano de Seguridad Social (IMSS), Guadalajara, Jalisco, Mexico
  • Martinez-Mejia, Victor Manuel, Centro Medico Nacional de Occidente (CMNO). Instituto Mexicano de Seguridad Social (IMSS), Guadalajara, Jalisco, Mexico
  • Gomez-Navarro, Benjamin, Centro Medico Nacional de Occidente (CMNO). Instituto Mexicano de Seguridad Social (IMSS), Guadalajara, Jalisco, Mexico
  • Mendoza cerpa, Claudia Alejandra, Centro Medico Nacional de Occidente (CMNO). Instituto Mexicano de Seguridad Social (IMSS), Guadalajara, Jalisco, Mexico
  • Rodriguez, Viridiana, Centro Medico Nacional de Occidente (CMNO). Instituto Mexicano de Seguridad Social (IMSS), Guadalajara, Jalisco, Mexico
  • Velasco, Sandra Fabiola, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Andrade-Sierra, Jorge, Centro Medico Nacional de Occidente (CMNO). Instituto Mexicano de Seguridad Social (IMSS), Guadalajara, Jalisco, Mexico
Background

The renal histologically evidence of Systemic Lupus Erythematosus (SLE) and its classic situation for full house positive immunostaining detection; IgA, IgM, IgG, C1q and C3 deposits; occurs in lupus nephritis (LN). However, these pattern may be present in the absence of SLE on other entities such as liver disease, diabetes mellitus, infections and other glomerulonephritis (GN).

Methods

Records of 22 kidney biopsies with full-house IF nephropathy with negative clinicopathological spectrum for SLE. We evaluated at the time of renal biopsy findings including demographics, clinical presentation, laboratory data, renal biopsy findings and clinical follow up.

Results

Of the 22 full house IF nephropathy biopsies the histological diagnoses included minimal change disease (5%), focal and segmental glomerulosclerosis (13%), membranous GN (27%), IgA nephropathy (9%), membranoproliferative GN (27%), C1q GN (5%), post infectious GN (9%) and ANCA associated GN (5%). Six patients originally with full house with no SLE spectrum developed SLE in a range between 8 to 20 months of clinical follow up.

Conclusion

Full-house IF pattern it is commonly associated with morphologic evidence of LN. Although it is a characteristic not exclusively of LN, our report showed that full nephropathy is present in other type of GN. Furthermore, 6 of 22 patients on clinical follow up developed clinical and not just morphologic characteristics of SLE. Full house nephropathy is still a diagnostic challenge, may be associated with other systemic and infectious diseases. As clinicians we should insist in strict follow-up and always be alert of possible develop overt of SLE .

Characteristic Baseline
Sex – No. (%)
Male/Female
12 (55) / 10 (45)
Age –yr27 ± 11
Clinical presentations – No. (%)
Nephrotic syndrome
Nephritic syndrome
Hematuria
Non nephrotic proteinuria
13 (60)
1 ( 5)
3 (13)
5 (22)
Laboratory variables
Serum creatinine – mg/dl
Albumin – g/dl
Proteinuria – g/24hrs
0.59 ± 0.46
2.98 ± 0.52
4.67 ± 4.36

Mean ± SD