Correlative Study Of Pathological Type And Clinical Characteristic In Lupus Nephritis

Background:Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. It has awide spectrum of clinical manifestations, of which renal failure is the most severe and the major cause of death. Lupus nephritis (LN) refers to the kidney disease caused by SLE. LN is associated with a worse prognosis than non-renal SLE. The pathogenesis of LN is complex and it is more difficult to decide diagnosis and treatment because of the multiplicity of pathology change and clinical manifestation. We prefer to improve the diagnosis level of LN by the retrospective study.Objective:To investigate the renal pathology character and the interrelationship with the clinical manifestation, laboratory examination, immunologic test, SLEDAI score and other renal pathology index by retrospective.Method: 165 LN patients were included in this study, who choosed in the Department of Nephrology, General Hospital of Jinan Military Command Region from 2003 to 2010. Collected the data of clinical manifestation, laboratory examination and renal pathology to analyze by statistics method and the histological classifications were categorized according to 2003 ISN/RPS classification.Result:The study included 165 patients,in which 140 female patients and 25 male patients and the male to female ratio was 1:5.6. The years old range from 8 to 62 with a mean age at 31.08±1.92 years. Renal biopsy revealed the most type was type IV in 61(37%), the second was type V in 28 (17%), type III was the third in 25 (15.1%), typeⅡin 20 (12.1%) and type V+IV only in 19 (11%). Nephrotic syndrome was the most common clinical manifestations (53.3%) and nephritic syndrome was the second (26%). TypeⅡwas mainly as nephritic syndrome and nephrotic syndrome (50% and 35% respectively), typeⅣ,ⅤandⅤ+Ⅳwere mainly as nephritic syndrome(55.7%, 67.9% and 52.6% respectively), renal failure is mainly presented in typeⅣ. The incidence of hypertension in typeⅣwas highest than others. There was no correlation between the clinical manifestation outside renal and pathology type. The level of 24H urine protein and serum creatinine in typeⅡ,Ⅳ,ⅤandⅤ+Ⅳpatients were higher obviously than typeⅠ,ⅡandⅢ. The incidence of anemia in typeⅣandⅤ+Ⅳwas more frequent than others. There ale no significant differences among the positive rates of autoantibodies of various pathological types(P>0.05). The scores of AI, CI and TIL were different significantly in different pathological type and the scores of AI and CI were highest in typeⅣandⅤ+Ⅳ. There was some relationship between the scores of SLEDAI and AI.Conclusion:l.Type IV and V+IV was the most common pathological type in this study.2. There was determinate relationship between the clinical manifestation and the data of laboratory. Pathology check cannot be subtitute by them.3. The score of AI and CI were highest in typeⅣandⅤ+Ⅳ.4. There was correlation between the scores of SLEDAI and AI.