晚发性狼性炎的临床病理特征和结果:一个单一中心的经验
Harshita Sharma1, Anupma Kaul2, Sourya Sourabh Mohakuda1
1Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Rheumatology international
|June 19, 2023
概括
晚期发病的狼性炎 (LN) 很少见,通常以衰竭的形式出现. 由于这些患者的感染率很高,谨慎的免疫抑制是至关重要的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 类风湿病学 类风湿病学
- 内部医学 内部医学
背景情况:
- 系统性红斑狼 (SLE) 通常影响年轻人.
- 晚发性SLE (47岁以后) 的脏参与较少,但存在独特的挑战.
研究的目的:
- 研究晚发性狼性炎 (LN) 的临床,血清学和组织病理学特征.
- 了解与晚期LN相关的结果和并发症.
主要方法:
- 对在2000年至2020年期间诊断的活检证明的晚发性LN患者的回顾性审查.
- 对患者人口统计,临床表现,脏活检结果,治疗方案和随访数据的分析.
主要成果:
- 晚期发作的LN占活检患者的1.2%,主要影响女性 (90.65%).
- 功能衰竭很常见 (52.8%),急性损伤 (AKI) 是最常见的表现 (28.3%).
- 第四类LN在组织病理学上是最常见的 (43.5%),三分之一的病例中出现了新月. 感染并发症的高发病率 (21%),包括结核病 (13.2%),导致显著的死亡率 (75%的死亡).
结论:
- 晚期LN是一种罕见的疾病,经常出现功能衰竭.
- 脏活检对于指导免疫抑制疗法至关重要,平衡疗效与感染的高风险.
- 在这种脆弱的患者群体中,明智地使用免疫抑制药物至关重要,以减轻严重的感染并发症和死亡率.
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