Abstract: SA-PO269
Occurrence of IgA Nephropathy with Lupus Nephritis
Session Information
- Clinical Glomerular Disorders: Vasculitis, C3G, IgAN
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Glomerular
- 1005 Clinical Glomerular Disorders
Authors
- Malvar, Ana, HOSPITAL FERNANDEZ, Buenos Aires, Argentina
- Alberton, Valeria Gabriela, hospital Fernandez, Buenos Aires, Argentina
- Lococo, Bruno Jorge, DIAVERUN, Buenos Aires, Argentina
- Tais, Renzo, Fernandez Hospital, Buenos Aires, Argentina
- Ferrari, Matias, Fernandez Hospital, Buenos Aires, Argentina
- Delgado, Pamela, Fernandez Hospital, Buenos Aires, Argentina
- Sarabia, Angelica, Fernandez Hospital, Buenos Aires, Argentina
- Rovin, Brad H., Ohio State University Wexner Medical Center, Columbus, Ohio, United States
Background
IgA nephropathy (IgAN) without lupus nephritis (LN) has been seen in a small number of patients with SLE who developed proteinuria. The coincident occurrence of IgAN and LN has not been previously reported. We describe 5 patients with LN who had prominent mesangial IgA deposits that persisted after induction therapy for LN resulted in resolution of the other immune complexes.
Methods
A cohort of 131 proliferative LN patients had a kidney biopsy for diagnosis (Bx1) and again after induction with steroids plus MMF or cyclophosphamide (Bx2). Mean follow up was 42 ±7 months.
Results
Five patients (4 females; average age 38) were found to have dominant IgA deposits before and after induction therapy for LN. LN class, immunofluorescence pattern, serum creatinine (Scr), and 24-hour proteinuria (prot) are described in the table. At Bx2 20% of IgA-dominant patients achieved a complete renal remission (prot ≤ 0.5g/d; normal SCr mg/dl) compared to 41% of the whole cohort. CKD developed in 60% of the IgA-dominant patients and 20% of the whole cohort after 4 years of follow-up.
Conclusion
We identified a small subset of patients with proliferative LN who simultaneously appeared to have IgAN. This subset of patients did not appear to do as well as with induction therapy or during long-term follow-up of a contemporaneous cohort of proliferative LN patients
| subject | Bx1 | Bx1 | Bx1 | Bx1 | Bx2 | Bx2 | Bx2 |
| class | IgA/G/M | C1q/C3 | Scr/prot | IgA/G/M | C1q/C3 | Scr/prot | |
| 1 | 3 | 3/3/2 | 2/1 | 0.7/3.5 | 3/1/2 | 0/0 | 0.6/0.7 |
| 2 | 4 | 3/3/0 | 2/2 | 2.2/5 | 3/1/0 | 0/2 | 1.3/0.8 |
| 3 | 3 | 3/1/3 | 2/1 | 0.9/4.3 | 3/1/0 | 0/1 | 0.8/0,2 |
| 4 | 4 | 3/3/2 | 1/2 | 1.2/6.5 | 3/0/0 | 0/0 | 1.2/1.1 |
| 5 | 3 | 3/3/2 | 2/2 | 1.3/4 | 3/0/0 | 0/2 | 1.5/1.4 |