Comparison of lupus patients with early and late onset nephritis: a study in 71 patients from a single referral center
Comparison of lupus patients with early and late onset nephritis: a study in 71 patients from a single referral center
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DOI：
10.1186/s42358-019-0105-5
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发表时间：
2020-01-01
影响因子：
2.3
通讯作者：
Skare, Thelma L.
中科院分区：
文献类型：
--
作者：
Delfino, Juliana;Santos, Thiago Alberto F. G. dos;Skare, Thelma L.
研究背景系统性红斑狼疮（SLE）常发生肾炎，可加重疾病的发病率和死亡率。了解这种表现的所有特征有助于及时识别和治疗。目的比较早发性肾炎与晚发性肾炎的临床资料、血清学特征及治疗反应的差异。方法回顾性分析71例经病理活检证实的SLE肾炎患者，分为早期肾炎组（发病5年内诊断为肾炎）和晚期肾炎组（发病5年后诊断为肾炎）。从图表中收集流行病学、血清学、临床和治疗数据并进行比较。结果在该样本中，70. 4%为早发性肾炎，29.6%为晚发性肾炎。在流行病学、临床、血清学特征、SLICC和SLEDAI方面没有发现差异，除了晚发性肾炎患者在肾炎诊断时年龄较大（p = 0.01）。关于肾活检分类、C3和C4水平、血清肌酐、24 h蛋白尿和治疗应答率，两组相似（p = NS）。早发性肾炎患者的血红蛋白水平低于晚发性肾炎患者（p = 0.02）。结论SLE患者在发病前5年内以肾炎为主。当比较早发性和迟发性肾炎的疾病特征或治疗结果时，没有发现重大差异。
Background Nephritis occurs frequently in systemic lupus erythematosus (SLE) and may worsen disease morbidity and mortality. Knowing all characteristics of this manifestation helps to a prompt recognition and treatment. Aim To compare the differences in clinical data, serological profile and treatment response of nephritis of early and late onset. Methods Retrospective study of 71 SLE patients with biopsy proven nephritis divided in early nephritis group (diagnosis of nephritis in the first 5 years of the disease) and late nephritis (diagnosis of nephritis after 5 years). Epidemiological, serological, clinical and treatment data were collected from charts and compared. Results In this sample, 70. 4% had early onset nephritis and 29.6% had late onset. No differences were noted in epidemiological, clinical, serological profile, SLICC and SLEDAI, except that late onset nephritis patients were older at nephritis diagnosis (p = 0.01). Regarding renal biopsy classification, C3 and C4 levels, serum creatinine, 24 h proteinuria and response rate to treatment the two groups were similar (p = NS). Patients with early onset had lower levels of hemoglobin at nephritis onset than those of late onset (p = 0.02). Conclusions Most of SLE patients had nephritis in the first 5 years of disease. No major differences were noted when disease profile or treatment outcome of early and late onset nephritis were compared.