Histological features of antiphospholipid nephropathy in patients with Systemic Lupus Erythematosus

To determine the histological features of renal biopsies of Systemic Lupus Erythematosus (SLE) patients with and without antiphospholipid antibodies in Saudi population.

Cross-sectional, comparative study.

King Khalid University Hospital, Riyadh, Saudi Arabia, from January to December 2013.

Consecutive SLE patients admitted to King Khalid University Hospital, Riyadh for renal biopsy for evaluation of proteinuria or deterioration of renal function were recruited. SLE patients with renal involvement were divided in two groups. Group one included patients with positive APS antibodies and group two included patients with negative APS antibodies. The histological features of renal biopsies of the two patients groups were compared. Data was analyzed using simple statistical analysis.

The mean age of APS antibodies-positive patients was 30.37 ± 10.714 years while mean age of APS negative patients was 33.62 ± 11.717 years (p=0.224). Twenty five (83.33%) patients were females and 5 (16.67%) patients were males in APS positive patients while 42 (89.36%) were females and 5 (10.63%) were males in group two. Acute lesions like thrombotic microangiopathy were in 2 (6.7%) of APS positive patients while chronic lesions like focal cortical atrophy was found in 6 (20%) and fibrous intimal hyperplasia was found in 9 (30%). Other significant histological findings in APS antibodies positive group were glomerular basement membrane wrinkling in 12 (40%), glomerular double wall contour in 17 (56.7%), fibrous adhesions in 11 (36.7%) patients with APS antibodies.

Systemic Lupus Erythematosus (SLE) patients with positive APS antibodies has specific histological findings suggesting an important role of APS antibodies in the pathogenesis of APS nephropathy.