Abstract: FR-PO734
Idiopathic Non-Lupus Full House Nephropathy Compared to Lupus Nephritis
Session Information
- Clinical/Diagnostic Renal Pathology and Lab Medicine - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Glomerular
- 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine
Authors
- Dias, Cristiane B., University of Sao Paulo, Brazil, São Paulo, Brazil
- Testagrossa, Leonardo A., University of São Paulo, São Paulo, Brazil
- Malheiros, Denise M., University of Sao Paulo, Sao Paulo, Brazil
- Jorge, Lectícia, University of São Paulo, São Paulo, Brazil
- Woronik, Viktoria, None, Salvador, Brazil
Background
Full house pattern is defined by the concomitant deposition of immunoglobulins G, A and M and two components of the complement system in renal tissue identified by immunofluorescence. Non-lupus full house nephropathy (NLFN) is the patients with full house pattern but which did not fulfill criteria for the diagnosis of systemic lupus erythematosus. Due to the rarity of NLFN we studied our case series comparing with lupus nephritis.
Methods
All biopsies from January 2000 to September 2016 with full house pattern were collected from the Pathology and Nephrology Discipline at Hospital das Clinicas of São Paulo. Patients with confirmed diagnosis of Lupus Nephritis were used for comparison. Clinical and laboratory data at the time of renal biopsy and at the end of follow-up were retrieved.
Results
In this period, 16 patients had a diagnosis of non-lupus full house nephropathy, with a mean age of 36.8 ± 10.7 years, with 10 men (62.5%), median serum creatinine of 1.1 (0.8-1.0) mg/dL and mean proteinuria of 7.0 ± 4.6g/day. The most frequently optical microscopy pattern found was membranoproliferative glomerulonephritis in 7 cases (43.80%) and membranous glomerulopathy in 4 cases (25%). Regarding the evolution, 3 patients fulfilled criteria for systemic lupus erythematosus, 2 patients were diagnosed with schistossomosis and 1 cryoglobulinemia. Ten patients with idiopathic form were compared with a group with lupus nephritis and did not have difference with respect to renal survival [Table1].
Conclusion
Non-lupus full house nephropathy is a rare condition, affecting equality men and women and has same renal survival than lupus nephritis.
Comparison of clinical and laboratory data on the diagnosis and renal outcomes of patients with idiopathic non-lupus full house nephropathy vs lupic nephritis
| Idiopathic Non Lupus Full House Nephropathy | Lupus Nephritis | p | |
| Age (years) | 31.5 ± 10.1 | 32.0 ± 8.7 | 0.89 |
| Gender (M/F) | 9/6 | 1/19 | 0.0006 |
| Serum Creatinine (mg/dL) | 0.9 (0.7-2.3) | 0.9 (0.6-2.5) | 0.94 |
| Proteinuria (g/day) | 6.3 (3.1-10.3) | 4.1 (3.6-6.7) | 0.55 |
| Arterial hypertension (%) | 50 | 60 | 0.20 |
| Hematuria (%) | 85.7 | 52 | <0.0001 |
| Dialysis or death (%) | 40 | 30 | 0.69 |
| Serum Albumin (g/dL) | 2.2(1.9-2.9) | 2.5(1.9-3.3) | 0.54 |
| Hemoglobin (g/dL) | 12.1 (10.1-12.4) | 11.9 (9.6-13.2) | 0.60 |
| Follow up (months) | 72.4 ± 49.3 | 105.8 ± 2.6 | 0.0028 |