[The spectrum of lupus nephropathy]

Clinical manifestations and immunological characteristics in a series of 15 patients with systemic lupus erythematosus and renal involvement are presented. These findings have been correlated to different pathologic lesions and compared to another series of patients without renal involvement. The overall rate of renal involvement was 25 percent, with ages ranging from 14 to 47 years. A female predominance was noticed. Histopathologic findings were as follows: focal glomerulonephritis (five cases), and minimal changes (one case). Under a histological glomerulonephritis (two cases); membranous glomerulonephritis (one case), and minimal change (one case). Under a histological standpoint the earliest lesions had the worse prognosis. Patients with diffuse glomerulonephritis showed a high degree of renal function impairment. Urinary infection was present in half of the cases. A significant hyperlipidemia was found in patients with nephrosis. Proteinuria and abnormal urinary sediment were common findings in all histologic types. Antinuclear antibodies, were positive in 14 cases, with statistical significant high titres in diffuse glomerulonephritis. Serum immunoglobulins IgG and IgA were elevated. Decrease of serum complement levels (C3, C4, C3PA and C5) were found in patients with renal involvement.