title: Clinical-pathological features and prognosis of thrombotic thrombocytopenic purpura in patients with lupus nephritis.
abstract: 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.
authors.affiliation: Research Institute of Nephrology, Jinling Hospital, Nanjing, People's Republic of China. tangdr@publicl.ppt.js.cn
authors.forename: Tang
authors.initials: T
authors.lastname: Zheng
authors.forename: Luo
authors.initials: L
authors.lastname: Chunlei
authors.forename: Wang
authors.initials: W
authors.lastname: Zhen
authors.forename: Liu
authors.initials: L
authors.lastname: Ping
authors.forename: Zhang
authors.initials: Z
authors.lastname: Haitao
authors.forename: Hu
authors.initials: H
authors.lastname: Weixin
authors.forename: Zeng
authors.initials: Z
authors.lastname: Caihong
authors.forename: Chen
authors.initials: C
authors.lastname: Huiping
authors.forename: Liu
authors.initials: L
authors.lastname: Zhihong
authors.forename: Li
authors.initials: L
authors.lastname: Leishi
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents