Clinicopathologic Characteristics And Prognosis In Sjogren’s Syndrome Syndrome With Renal Involvement

Objective:To analyze clinical manifestntions, immunological characteristics, pathological changes and prognosis in primary prognosis in primary Sjogren’s syndrome syndrome with renal involvement.Methods:387patients with pSS, were enrolled in this retrospective study. Among these patients the198patients were with renal involvement and189patients without renal involvment. The data of the two groups were analyzed in clinical manifestations, biood examination, urine examination and immunological characteistics.72patients in the group with renal involvement have made renal biopsies.Results:387patients with pSS(female/male345/42cases),were an average age of (55.3±13.2)years old.198patients with renal involvement (female/male168/30cases),were an average age of (55.3±13.2)years old. There are not statistical difference in the incidence rate of xerostomia、phthalmoxerosi、fever、arthritis and dental ulcer between two groups. In serum level of ANA、anti-SSB、C3、IgA、IgM, there was not significantly difference between the two groups(P>0.05).But, the serum RF and IgG of the group with renal volvement was significantly higher than the patients without renal(P<0.05). In the198patients with renal involvement,102patients(51.5%) developed renal tubular acidosis type I (RTA I).Among shese RTA I patiesnts,54patients presentes hypopotassaemia;12patients developed hypokalemic plegia,30patients with hrolithiasis were proved,6patiests with osteoporosis;69patients presented with overt renal glomerulus impairment,36cases were proved with nephrotic syndrome(NS),and33cases were proved with hronic glomerulonephritis; In81patients with renal failure, including27o in CKD1stage,18in CKD2stage,9in CKD3stage,15in CKD4stage,12in the stage of CKD5.Among shese patients made renal biopsie,light microscopy showed chronic interstitial nephritis(IN,.69/72), mesangial proliferative glomerulonephritis (36/72),hyperplastic and sclerosing glomerulonephritis (9/72), partly sclerosing glomerulonephritis (9/72) and membranous nephropathy (6/72).Immunofluorescent examination revealed:IgG in21patients(29.1%),IgA in21(29.1%),IgM in33(45.8%), C3in12(16.6%), C4in18(25%)and Clq in15(20.8%).66cases of Renal biopsies were followed (8～30)months, expecting the patient died of encephalorrhagia all the other patients were survival,and the renal functions were steady or better.Conclusions:1. The pSS patients with renal involvement mainly showed interstitial nephritis.however, the happening of glomerulonephritis are not a low incidence rate;2. Rheumatoid factor(RF)or IgG is significantly about renal involvement in patients with pSS.3. When renal involvement have been found, renal biopsies is a necessary test for patients with pSS.