Abstract: SA-PO0821
Histological Predictors of Treatment Response in Lupus Nephritis: Review of Immunofluorescence and Electron Microscopy Findings
Session Information
- Glomerular Diseases: Management, Evolving Strategies, and Practice-Changing Advances
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Lewis, Sarah J., The University of Manchester Faculty of Biology Medicine and Health, Manchester, England, United Kingdom
- Bani Issa, Bayan Abdallah, Jordan University of Science and Technology, Irbid, Irbid Governorate, Jordan
- Ciuculete, Catinca, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Rizvi, Syed Mustafa Ali, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Chaudry, Summaya Sohail, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Balasubramanian, Praveen Shankar, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Brix, Silke R., The University of Manchester Faculty of Biology Medicine and Health, Manchester, England, United Kingdom
Background
Lupus nephritis is associated with significant morbidity and mortality. The histology at the time of diagnosis, the classification and updated activity and chronicity indices show mild to moderate associations with treatment response but have not demonstrated significant prediction except for the degree of IFTA. A Lupus score predicting outcome is urgently needed.
Methods
We conducted a single centre retrospective analysis investigating 113 biopsies of 78 lupus nephritis patients and reviewed the light microscopy, immunofluorescence and electron microscopy for clinicopathological associations with the 6- and 12-months treatment response in proteinuria. The median age of patients was 45 years at the time of biopsy with a median eGFR of 85.5 umol/l.
Results
Patients with full house immunofluorescence showed a higher proteinuria at 6 and 12 months (p=0.04). Patients with subepithelial deposits on their EM also showed a higher proteinuria at 6 and 12 months compared to patients with subendothelial and/or mesangial deposits only (p=0.018 and p=0.002, respectively). There was no difference in the 6- and 12-months outcome when comparing the intensity of deposits (mild-moderate vs severe).
Conclusion
Analysing IF and EM, the intensity of deposition did not associate with outcome, but the type of deposition and location did. Patients with full house IF and subepithelial deposits did have worse proteinuria at 6 and 12 months post biopsy than those without. IF and EM aspects of histology may be important disease aspects worthwhile to incorporate in future updates of the lupus activity score.
Funding
- Government Support – Non-U.S.