Anti-cardiolipin antibody and renal disease: a report three cases.
Anti-cardiolipin antibodies have been linked to recurrent arterial and venous thrombosis in multiple organs. We present a biopsy-documented report of thrombotic renal disease apparently attributable to circulating anti-cardiolipin antibodies. One patient had primary anti-cardiolipin syndrome, one had mild SLE, and the third had a mild lupus-like syndrome. All three patients had a clinical course dominated by repeated multi-organ system thrombosis. Renal biopsy disclosed thrombosis at the level of the glomerular capillaries, arterioles, and interlobular arteries--similar to that described in other thrombotic microangiopathies. Renal thrombosis was not associated with active endocapillary proliferative lupus nephritis, suggesting a mechanism independent of subendothelial immune deposit injury. Renal presentation was variable, ranging from asymptomatic mild proteinuria to nephrotic-range proteinuria, renal insufficiency, and hypertension.
D'Agati
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V
Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, NY 10032.
Kunis
C
C
Williams
G
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Appel
G B
GB
D000328:Adult; D000906:Antibodies / Q000502:physiology*; D001158:Arteries / Q000473:pathology; D001706:Biopsy; D002196:Capillaries / Q000473:pathology; D002308:Cardiolipins / Q000276:immunology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000150:complications / Q000276:immunology / Q000473:pathology*; D007678:Kidney Glomerulus / Q000098:blood supply; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008856:Microscopy, Fluorescence; D013927:Thrombosis / Q000473:pathology
D000906:Antibodies; D002308:Cardiolipins