NEFRITIS LUPICA PDF

Asociada con lesiones de clase II c. Asociada con lesiones de clase III d. Puede haber cualquier grado de hipercelularidad mesangial. Kidney Int.

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Summary Lupus nephritis LN is a major cause of morbility and mortality in patients with systemic lupus erythematosus SLE. It is important that combinations of membranous and proliferative glomerulonephritis should be reported individually in the diagnosis line, as well as the diagnosis should also include notations for any concomitant vascular or tubolointersticial lesions, therefore, one of the main advantages of this classification is that it provides a clear and unequivocal description of the various lesions and classes of lupus nephritis, allowing a better standardization and giving a basis for further clinicopathologic studies.

Otherwise, despite the development of new modalities of treatment in LN, cyclophosphamide remains the preferred initial treatment for severe forms of LN like proliferative and membranous glomeru- lonephritis associated with both, lesions of class III or class IV; nevertheless, the optimal treatment remains challenging because of the adverse effects associated with cyclophosphamide like sustained amenorrhea, infertility, increased susceptibility to infection, bone marrow suppression, hemorrhagic cystitis, and malignancy.

Finally, due to these adverse effects new alternative approaches to the treatment of LN are desirable and also for some patients who fail to achieve remission with standar cytotoxic therapy and for who relapse when thera- py is reduced. For refractory disease, new immu- nosuppressive and immunomodulating agents, immunoablative high dose of cyclophosphamide, apheresis and the biological response modifiers can be consider.

Key words: lupus nephropathy, systemic lupus erythematosus, treatment. Al menos uno de los siguientes debe estar presente 10 : 1. Biopsia renal que demuestre glomerulonefritis mesangial clase IIb, proliferativa focal, proliferativa difusa o membranosa.

Proteinuria mayor de 1 gramo en orina de 24 horas. Cuerpos ovales grasos o cilindros granulosos, hialinos o eritrocitarios en orina. Por cada uno de los criterios mencionado se deben ex- cluir otras causas.

Anaya y cols. Importancia de la raza La raza es un factor de riesgo independiente para el desarrollo de falla renal progresiva debido a NL proliferativa difusa. En ambos centros el riesgo de enfermedad renal terminal fue significativamente mayor para los afro-americanos, a pesar del trata- miento intensivo con esteroides y pulsos de ciclofosfamida.

Cameron JS 2.

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