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Kidney involvement in primary Sjögren's syndrome
Scandinavian Journal of Rheumatology. Supplement
|January 1, 1986
Summary
Kidney involvement is common in primary Sjögren's syndrome, affecting renal function and structure. Early detection through renal tests and biopsies is crucial for managing this extraglandular manifestation.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Primary Sjögren's syndrome (pSS) is an autoimmune disease primarily affecting exocrine glands.
- Kidney involvement is a recognized extraglandular manifestation of pSS.
- Common histopathological findings include interstitial lymphocytic infiltrate, tubular atrophy, and fibrosis, with immune complex glomerulonephritis in sporadic cases.
Purpose of the Study:
- To investigate the spectrum and prevalence of kidney involvement in Greek patients with pSS.
- To assess clinical and subclinical renal manifestations in pSS.
Main Methods:
- Retrospective analysis of 36 Greek patients with pSS.
- Routine renal laboratory tests: serum creatinine, creatinine clearance, 24-hour urine protein, urinalysis.
- Plain abdominal X-ray.
- Renal tubular acidosis assessment via acute acid loading test (NH4Cl) in 15 patients.
- Renal biopsy in 7 patients.
Main Results:
- Nephrolithiasis in 2 patients, severe proteinuria (>3.5 g/day) in 2 patients.
- Histology revealed membranous and membranoproliferative glomerulonephritis in proteinuric patients.
- Renal tubular acidosis diagnosed in 5 of 15 patients (1 complete, 4 incomplete).
- Mild interstitial nephritis found in 5 of 7 biopsied patients; 2 of these also had RTA.
Conclusions:
- Renal involvement, both clinical and subclinical, is frequent in primary Sjögren's syndrome.
- A spectrum of renal pathologies, including glomerulonephritis, interstitial nephritis, and renal tubular acidosis, can occur.
- Comprehensive renal evaluation is essential for patients with pSS.