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[Anti-cardiolipin antibody and renal microthrombi in lupus nephritis]
S Wakai1, O Matsumura, T Koike
1Department of Medicine, Kidney Center, Tokyo Women's Medical College.
Insights
Anticardiolipin (ACL) antibodies are strongly associated with renal microthrombi in patients with lupus nephritis (LN). This finding highlights a significant link between ACL and kidney microthrombosis in active disease.
Area of Science:
- Nephrology
- Immunology
- Pathology
Context:
- Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect the kidneys, leading to lupus nephritis (LN).
- Microthrombi in renal tissue are a pathological feature associated with kidney damage in LN.
- Anticardiolipin (ACL) antibodies are autoantibodies implicated in thrombotic events.
Purpose:
- To investigate the relationship between anticardiolipin (ACL) antibody presence and the occurrence of renal microthrombi in patients diagnosed with lupus nephritis (LN).
Summary:
- The study analyzed sera and renal biopsies from 47 patients with LN. ACL antibodies were detected in 60% of patients with LN and 83% of those with WHO IV (diffuse proliferative LN: DPLN).
- Renal microthrombi were significantly more prevalent in patients with DPLN (61%) compared to all LN patients (34%).
- A higher prevalence of renal thrombosis was observed in patients with ACL antibodies (46%) versus those without (16%). ACL positivity was 81% in cases with renal microthrombi versus 48% in cases without.
Impact:
- Findings suggest a strong association between ACL antibodies and renal microthrombi in active lupus nephritis.
- This association may have implications for understanding LN pathogenesis and identifying patients at higher risk for thrombotic complications.
- Further research could explore the clinical utility of ACL antibody testing in managing LN patients.
Abstract:
To evaluate the relationship between anticardiolipin (ACL) antibody and microthrombi in renal tissue, we examined sera and renal biopsies from 47 patients of systemic lupus erythematosus (SLE) with lupus nephritis (LN). ACL antibody was measured by an enzyme-linked immunosorbent assay (ELISA). Their renal tissues were examined for histological types of lupus nephritis according to the WHO classification and appearance of renal microthrombi. Positive ACL had been shown in 28 of 47 patients (60%) with LN and in 15 of 18 patients (83%) with WHO IV (diffuse proliferative LN: DPLN). Incidences of renal microthrombi were significantly higher in patients with DPLN (61%) than in patients with all LN (34%) (p less than 0.01). The prevalence of renal thrombosis in patients with ACL (46%) was significantly higher than without ACL (16%) (p less than 0.05). Incidence of positive ACL was 81% in the cases with renal microthrombi and 48% in the cases without them. These findings suggest that there is strong association between ACL and the renal microthrombi in active LN.