[Clinico-pathological correlations in lupus nephritis with reference to therapeutic and prognostic aspects (author's...

Since 1970 in 27 out of 46 patients with the diagnosis of systemic lupus erythematosus (SLE) a renal biopsy could be taken. The morphological outcome was followed in 14 patients with a total of 18 repeated biopsies. By light- and electron microscopy renal involvement was demonstrable in all patients. Four histologic subgroups could be differentiated: Mesangio-proliferative (MESLN, 14), focal proliferative (FLN, 6), diffus proliferative (DLN, 6), and membranous lupus nephritis (MLN, 1). Some biopsies demonstrated linear deposits with IgG/IgA-specificity. 2/27 patients only showed a clinical deteriorating course with progressive renal insufficiency despite steroid or steroid-azathioprine therapy. One patient with DLN died in terminal renal failure. The morphological follow-up showed an unfavourable course in 3/14 patients only. One MESLN demonstrated a transition to DLN, one DLN an increase of proliferative lesions and a second DLN focal and local sclerosis. In our experience renal involvement in SLE can adequately characterised and controlled by repeated be clinico-pathological correlations an aggressive therapeutic regimen is not indicated and can be avoided.