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Anti-cardiolipin antibody and renal disease: a report three cases

V D'Agati1, C Kunis, G Williams

  • 1Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, NY 10032.

Journal of the American Society of Nephrology : JASN
|November 1, 1990
PubMed

Insights

Anti-cardiolipin antibodies can cause recurrent thrombosis. This study documents thrombotic renal disease in three patients linked to these antibodies, highlighting a distinct kidney injury mechanism.

Area of Science:

  • Nephrology
  • Immunology
  • Rheumatology

Background:

  • Anti-cardiolipin antibodies are associated with recurrent arterial and venous thrombosis across multiple organs.
  • Thrombotic events are a significant concern in patients with anti-cardiolipin syndrome and systemic lupus erythematosus (SLE).

Observation:

  • A biopsy-documented case series of thrombotic renal disease attributed to anti-cardiolipin antibodies.
  • Patients presented with primary anti-cardiolipin syndrome, mild SLE, or a lupus-like syndrome.
  • Clinical courses were characterized by recurrent multi-organ system thrombosis.

Findings:

  • Renal biopsy revealed thrombosis in glomerular capillaries, arterioles, and interlobular arteries.
  • Thrombosis occurred independently of active endocapillary proliferative lupus nephritis.
  • Renal manifestations varied, including proteinuria, renal insufficiency, and hypertension.

Implications:

  • Circulating anti-cardiolipin antibodies can cause significant renal thrombotic disease.
  • This suggests a pathogenic mechanism for renal thrombosis separate from immune deposit injury in lupus.
  • Highlights the importance of considering anti-cardiolipin antibodies in unexplained thrombotic events affecting the kidneys.

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