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[Kidney damage in primary antiphospholipid syndrome].
Terapevticheskii Arkhiv
|August 28, 2001
Summary
Primary antiphospholipid syndrome (PAS) can cause kidney damage, leading to hypertension and proteinuria. Treatment for PAS nephropathy should include anticoagulants and antiplatelet agents alongside immunosuppressants.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Primary antiphospholipid syndrome (PAS) is an autoimmune disorder characterized by recurrent thrombosis and pregnancy morbidity.
- Renal involvement, or nephropathy, is a serious complication of PAS, impacting patient prognosis.
Observation:
- This study observed 6 patients with PAS and kidney involvement over a 10-year period.
- Clinical manifestations included arterial hypertension and isolated proteinuria, with most patients experiencing renal dysfunction.
- Laboratory findings revealed elevated anticardiolipin antibodies and/or lupus anticoagulant in all patients.
Findings:
- Histological examination of renal tissue showed thrombotic microangiopathy in both glomerular and extraglomerular vessels.
- Vascular changes included intimal proliferation, wall thickening, and lumen occlusion, alongside focal segmental glomerulosclerosis.
- These findings highlight a significant thrombotic process within the intrarenal vasculature in PAS patients.
Implications:
- The intrarenal thrombotic process in PAS necessitates novel therapeutic strategies.
- Current treatment approaches for PAS nephropathy should be expanded to include indirect anticoagulants and antiaggregants, in addition to immunosuppressive therapy.