期刊文献+

LUPUS NEPHRITIS COMPLICATED WITH MALIGNANT HYPERTENSION:FROM RENAL VASCULAR PATHOLOGY TO CLINICAL RELEVANCE 被引量:2

LUPUS NEPHRITIS COMPLICATED WITH MALIGNANT HYPERTENSION:FROM RENAL VASCULAR PATHOLOGY TO CLINICAL RELEVANCE
下载PDF
导出
摘要 Objective To investigate the clinical and pathological characteristics of lupus nephritis patients complicated with malignant hypertension.Methods We retrospectively studied 19 patients with lupus nephritis complicated with malignant hypertension who underwent renal biopsy between January 2002 and December 2006.Results Of 19 patients,3 were men and 16 were women,with a mean age of 24.4±7.7 years old.All had positive antinuclear antibodies and low serum complement was found in 13 patients.All were anemic and 12 of them were thrombocytopenic.Impaired renal function was found in 17 patients with an average serum creatinine of 184.5±88.9 μmol/L.Severe intrarenal arteriolar lesion was found in all patients.Six patients had lupus vasculopathy,11 patients had renal thrombotic microangiopathy lesion,2 had severe arteriosclerosis.All patients received steroids and immunosuppressive drugs,15 received angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptor blocker(ARB)with resultant well-controlled blood pressure.Thrombocytopenia and hemolytic anemia resolved remarkably.The renal function improved or recovered in 14 of 17 patients,and 3 developed end-stage renal disease on maintenance dialysis.Conclusions Severe intrarenal vascular lesion complicated with renal nephritis parallels clinical manifestation of malignant hypertension.Renal pathology is the key of treatment strategy emphasizing on the significance of renal vascular involvement and type.On the basis of immunosuppressive drugs and steroids to control systemic lupus activity,timely initiation of ACEI/ARB could be of benefit to blood pressure control and long term renal survival.
出处 《Chinese Medical Sciences Journal》 CAS CSCD 2008年第2期81-87,共7页 中国医学科学杂志(英文版)
关键词 lupus nephritis malignant hypertension renal pathology renal vascular involvement thrombotic microangiopathy 狼疮肾炎 恶性高血压 病理学 肾血管缠绕 血栓形成微血管病
  • 相关文献

参考文献12

  • 1杜勇,李幼姬,杨念生,陈伟英,李志坚,姜宗培,李广然,余学清.狼疮肾炎并发高血压729例相关因素分析[J].中华风湿病学杂志,2005,9(3):169-172. 被引量:5
  • 2姚刚,胡伟新,刘志红,曾彩虹,姚小丹,陈惠萍,黎磊石.弥漫增生性狼疮性肾炎的肾血管病变与临床和预后的关系[J].肾脏病与透析肾移植杂志,2002,11(3):211-217. 被引量:27
  • 3Weening JJ,D Agati VD,Schwartz MM,et al.Classification of glomerulonephritis in systemic lupus erythematosus revisited[].Kidney International.2004
  • 4Hawker G,,Gabriel S,Bombardier C,et al.A reliability study of SLEDAI:a disease activity index for systemic lupus erythe-matosus[].The Journal of Rheumatology.1993
  • 5Markowitz GS,D Agati VD.The ISN/RPS2003classification of lupus nephritis:an assessment at3years[].Kidney International.2007
  • 6Charney DA,NassarG,Truong L,etal."Pauci-Immune"pro-liferative and necrotizing glomerulonephritis with thrombotic mi-croangiopathy in patients with systemic lupus erythematosus and lupus-like syndrome[].American Journal of Kidney Diseases.2000
  • 7Kitiyakara C,Guzman NJ.Malignant hypertension and hypertensive emergencies[].Journal of the American Society of Nephrology.1998
  • 8DESCOMBES E,DROZ D,DROUET L,et al.Renal vascularlesions in lupus nephritis[].Medicine Baltimore.1997
  • 9Wilson WA,Gharavi AE,Koike T,et al.International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome[].Arthritis and Rheumatism.1999
  • 10Nochy D,Daugas E,Droz D,et al.The intrarenal vascular lesions associated with primary antiphospholipid syndrome[].Journal of the American Society of Nephrology.1999

二级参考文献17

  • 1Shayakul C, Ongajyooth L, Chirawong P, et al. Lupus nephritis in Thailand: clinicopathologic findings and outcome in 569 patients.Am J Kidney Dis, 1995, 26:300-307.
  • 2Naiker IP, Chrystal V, Randeree IG, et al. The significance of arterial hypertension at the onset of clinical lupus nephritis. Postgrad Med J, 1997, 73: 230-233.
  • 3Donadio JV, Hart GM, Bergstralh E J, et al. Prognostic determinants in lupus nephritis: a long-term clinicopathologic study. Lupus, 1995, 4: 109-115.
  • 4Baqi N, Moazami S, Singh A, et al. Lupus nephritis in children: a longitudinal study of prognostic factors and therapy. J Am Soc Nephrol, 1996, 7; 924-929.
  • 51999 World Health Organization-international Society of Hypertension Guidelines for Management of Hypertension. Guidelines subcommitteie. J Hypertension, i997,17:151-183.
  • 6Fofi C, Pecci G, Galliani M, et al. IgA nephropathy: multivariate statistical analysis aimed at predicting outcome. J Nephrol, 2001,14: 280-285.
  • 7Bombardier C, Gladman DD, Urowitz MB, et al. A disease activity index for lupus patients: the committee on prognosis study in SLE. Arthritis Rheum, 1992, 35: 630-640.
  • 8叶任高 张道友 刘冠贤.红斑狼疮[M].北京:人民卫生出版社,2001.158.
  • 9Dubois EL, Wallace DJ. Clinical laboratory manifestation of systemic lupus erythemtosus. In: Wallace DJ, Dubois EL, eds. Dubois Lupus Erythemtosus. Philadelphia: PA, Lea & Febiger, 1991. 581.
  • 10Petrin J, Rozmall B, Dolenc P. The dissociation of arterial hypertension and lupus glomerulonephritits in SLE. Blood Press, 1993,2:108-112.

共引文献30

同被引文献9

引证文献2

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部