Abstract: FR-PO736

Pure Lupus Membranous Nephritis with Only IgG Deposits on Immunofluorescence Behaves Like Full House Pattern

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Vajgel, Gisele, Hospital das Clinicas - UFPE, Recife, PE, Brazil
  • Oliveira, Camila Barbosa lyra, Hospital das Clinicas - UFPE, Recife, PE, Brazil
  • Costa, Denise Maria do nascimento, Hospital das Clinicas - UFPE, Recife, PE, Brazil
  • Vasconcelos, Carolina Andrade jordão, IMIP, Recife, PE, Brazil
  • Cavalcante, Maria Alina G.M., Hospital das Clinicas - UFPE, Recife, PE, Brazil
  • Valente, Lucila Maria, Hospital das Clinicas - UFPE, Recife, PE, Brazil
Background

Pure lupus membranous nephritis (LMN) may present with only IgG deposits on immunofluorescence (IF) resembling idiopathic membranous nephritis. We aim to evaluate if patients with LMN and only IgG (±C3) have the same outcome as those with IgG plus other Ig/C1q deposits.

Methods

Adult patients with a diagnosis of lupus (> 4 SLICC criteria) and pure LMN between 2004 and 2016 were retrospectively evaluated. Complete response, partial response and relapse were defined by KDIGO criteria.

Results

Thirty-one patients out of 42 were selected; the remaining was excluded due to lack of data or follow-up less than 12 months. Clinical characteristics are shown in Table 1.
Drugs used for treatment were different between groups at the beginning (p=0.02) and at 12mo (p=0.02), but more homogeneous at the end of follow-up (p=0.15). Complete and partial response for only IgG and IgG+Ig/C1q group were not different between groups at 12mo (71.4% vs 95%; p=0.16), 24mo (83.3% vs 92.3%; p=1.0) and at last follow-up (75% vs 95.6%; p=0.16).

Conclusion

Despite lack of full house pattern on IF, lupus membranous nephritis patients with only IgG deposits seems to have the same outcome as those with typical full house or IgG plus other Ig/C1q pattern.

Baseline characteristicsOnly IgG
N = 8
IgG+Ig/C1q
N = 23
p-value
Age* (±SD)31.4 (±9.7)28.5 (±9.1)0.46
Female, n(%)7 (87.5)21 (91.3)1
Mixed Race, n(%)2 (28.6)13 (56.5)0.39
SCr, mg/dL*0.91.00.76
SAlb, mg/dL*2.612.580.94
Proteinuria, g/24h*4.234.221
Hematuria, n(%)4 (57.1)9 (47.3)1
Hypertension, n(%)6 (75)11 (57.9)0.41
ANA, n(%)8 (100)17 (94.4)1
Low C3, n(%)2 (25)10 (62.5)0.19
Low C4, n(%)1 (14.3)4 (28.6)0.62
Outcome at last visit   
Complete or partial remission, n (%)6 (75)22 (95.7)0.16
Relapse, n (%)3 (37.5)7 (30.4)1
Doubling SCr, n (%)1 (12.5)0 (0)0.26
CrCl < 30, n (%)1 (12.5)1 (4.3)0.46
Follow-up, mo(±SD)41.5 (±13.8)38.2 (±18.3)0.60

*Mean