Clinical-pathological features and prognosis of thrombotic thrombocytopenic purpura in patients with lupus nephritis.
BACKGROUND
We investigated the clinical-pathological features and the prognosis of thrombotic thrombocytopenic purpura (TTP) in patients with lupus nephritis (LN).


METHODS
A retrospective analysis was performed on the clinical-pathological data and prognosis in 8 patients with LN complicating with TTP.


RESULTS
Thrombocytopenia and hemolytic anemia, neurologic symptoms, and renal dysfunction were the clinical manifestations in 8 patients. Six patients had fever. Eight patients presented with rapid progressive glomerulonephritis, and 1 patient with continuous gross hematuria. The histologic features of the 8 patients were thrombotic microangiopathy lesions. Immune-suppressive therapies were administrated in all patients, and blood purification therapy was applied in 7 patients. Three cases involved plasma exchange and/or immunoabsorption. Seven patients received a median follow-up of 12 months. One patient died, 3 cases received peritoneal dialysis, and 1 case failed to follow-up. During follow-up, 1 case was able to stop peritoneal dialysis, and 1 case changed to hemodialysis. The other 3 patients continued with stable renal function.


CONCLUSIONS
The patients with LN with TTP have severe clinical-pathological changes. Active treatment including renal replacement therapy, plasma exchange, and immunoabsorption are promising.
Zheng
Tang
T
Research Institute of Nephrology, Jinling Hospital, Nanjing, People's Republic of China. tangdr@publicl.ppt.js.cn
Chunlei
Luo
L
Zhen
Wang
W
Ping
Liu
L
Haitao
Zhang
Z
Weixin
Hu
H
Caihong
Zeng
Z
Huiping
Chen
C
Zhihong
Liu
L
Leishi
Li
L
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007163:Immunosorbent Techniques; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000098:blood supply / Q000473:pathology*; D008181:Lupus Nephritis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D011379:Prognosis; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D055815:Young Adult
D007166:Immunosuppressive Agents