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. 2014 Feb 4:2014:212597.
doi: 10.1155/2014/212597. eCollection 2014.

Clinicopathological characteristics and outcomes of Chinese patients with scanty immune deposits lupus nephritis: a large cohort study from a single center

Qiuyu Li  1 , Di Song  1 , Fengmei Wang  1 , Ying Tan  1 , Feng Yu  1 , Minghui Zhao  1
Affiliations

Clinicopathological characteristics and outcomes of Chinese patients with scanty immune deposits lupus nephritis: a large cohort study from a single center

Qiuyu Li et al. ScientificWorldJournal. .

Abstract

Objective: To assess clinicopathological characteristics of lupus nephritis patients with scanty immune deposits.

Methods: The data of patients with scanty immune deposits lupus nephritis were retrospectively analyzed. Plasma ANCA and complement components were detected.

Results: Among 316 cases with renal biopsy-proven lupus nephritis, 40 cases were diagnosed as scanty immune deposits. There were significantly higher value of serum creatinine (P = 0.002) and lower hemoglobin level (P = 0.009) and higher score of cellular crescents (P = 0.015) in scanty immune deposits group compared with immune complex deposits group. The frequency of positive plasma ANCA was significantly higher in scanty immune deposits group than that in immune complex deposits group (52.5% versus 10.1%, P < 0.001). As for comparisons of plasma complement components, there were significantly higher levels of C1q (P = 0.005) and Bb (P = 0.02) and lower level of factor H (P = 0.003) in scanty immune deposits group. The ratio of treatment failure was significantly higher in scanty immune deposits group than that in immune deposits group (42.5% versus 19.20%, P = 0.001). The renal outcomes were similar between the two groups.

Conclusions: Patients with scanty immune deposits lupus nephritis had more severe kidney damage. ANCA and activation of complement alternative pathway might be involved in the pathogenesis of the disease.

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Figures

Figure 1
Figure 1
Electron micrographs of cases with scanty immune deposits lupus nephritis. (a)–(c) showed one case of mesangial proliferative lupus nephritis. No electron dense deposits were seen in mesangial area and glomerular basement membrane. Diffuse effacement of foot processes was observed. (d)–(f) showed one case of diffuse proliferative lupus nephritis combined with renal thrombotic microangiopathy. Glomerular endothelial cell (black pointer) was swollen, with increased mesangial matrix (d). Severe widening of subendothelial space (black arrow) with fluffy material and irregular cell projections; few of electron dense deposits were identified at higher magnification ((e), (f)). ((a), (d), original mag. ×10000) ((b), (c), (e), and (f), original mag. ×20000).
Figure 2
Figure 2
Comparison of renal outcomes between patients with scanty immune deposits (Group 1) and immune complex deposits lupus nephritis (Group 2).
Figure 3
Figure 3
Comparison of renal outcomes between patients with scanty immune deposits crescentic lupus nephritis (Group 1) and immune complex deposits class IV lupus nephritis (Group 2).
See this image and copyright information in PMC

References

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