Abstract: FR-PO1100
Evaluation of the Full-House Immunofluorescence Pattern (FH) in Patients Without Systemic Lupus Erythematosus (SLE): A Single Centre Observation Study
Session Information
- Glomerular Diseases: Clinical, Outcomes, Trials - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Kouki, Pinelopi, Hippokration Hospital of Arhens, Athens, Greece
- Damianaki, Aikaterini A., Hippokration Hospital of Arhens, Athens, Greece
- Chalkia, Aglaia, Hippokration Hospital of Arhens, Athens, Greece
- Giannou, Panagiota E., Hippokration Hospital of Arhens, Athens, Greece
- Gakiopoulou, Harikleia, University of Athens, Athens, Greece
- Vassilopoulos, Dimitrios, National and Kapodistrian University of Athens School of Medicine, ATHENS, Greece
- Petras, Dimitrios I., Hippokration Hospital of Arhens, Athens, Greece
Background
Strong interest is shown recently for FH pattern in patients without SLE nephritis. The purpose of the study is to identify patients with the above-mentioned entity and to evaluate clinical-laboratory findings and outcomes.
Methods
It consists of 8 patients with a FH pattern, defined as concomitant deposition of immunoglobulins (IgA, IgM, IgG) and two complement factors (C3, C1), non-diagnosed SLE who have undergone kidney biopsy over 4 years. Existing biopsies were reassessed by a nephropathologist and categorized according to the international histological classification of SLE. Anthropometry, eGFR, proteinuria, clinical course and histological findings were recorded.
Results
Two groups, idiopathic FH-non-lupus-nephropathy (iFHN) (n = 4) were identified based on the absence of histological findings defining specific glomerulonephritis(GN) (e.g. absence of PLA2R-antigen expression etc.) and secondary FH-non-lupus-nephropathy (sFHN) (n = 4) (e.g., expression of PLA2R-antigen, IgA +++, etc.). Patients with iFHN exhibit higher proteinuria (mean 9.45g / 24h), low eGFR (mean 28.8 ml / min / 1.73m2), significant consumption of C1q, C3, significant glomerulosclerosis and interstitial inflammation. The most common light microscopy pattern was membranoproliferative GN and response to personalized treatment was unsatisfactory. Patients with sFHN exhibit lower proteinuria (mean 7.32 g / 24 h), high eGFR (mean 81.1 ml / min / 1.73 m 2), mild deposition of C1q, C3, mild glomerulosclerosis and interstitial inflammation. The prominent light microscopy pattern was membranous nephropathy and response to treatment was satisfactory.
Conclusion
IFHN may reflect a clinicopathological entity with aggravating features and an unfavorable prognosis. Further studies are needed in order to corroborate that conclusion and to establish better approach to the treatment.