title: Renal involvement in antiphospholipid syndrome.
abstract: Antiphospholipid syndrome (APS) is an autoimmune disease defined by the presence of arterial or venous thrombotic events and/or pregnancy morbidity in patients who test positive for antiphospholipid antibodies (aPLs). APS can be isolated (known as primary APS) or associated with other autoimmune diseases, such as systemic lupus erythematosus (SLE; known as secondary APS). The kidney is a major target organ in APS and renal thrombosis can occur at any level within the vasculature of the kidney (renal arteries, intrarenal arteries, glomerular capillaries and renal veins); events reflect the site and size of the involved vessels. Histological findings vary widely, including ischaemic glomeruli and thrombotic lesions without glomerular or arterial immune deposits on immunofluorescence. Renal prognosis is affected by the presence of aPLs in patients with lupus nephritis and can be poor. In patients with SLE and aPLs, biopsy should be performed because inflammatory and thrombotic lesions require different therapeutic approaches. Renal involvement in patients with definite APS is treated by anticoagulation with long-term warfarin. The range of renal manifestations associated with APS is broadening and, therefore, aPLs have increasing relevance in end-stage renal disease, transplantation and pregnancy.
authors.affiliation: Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare and Università di Torino, Piazza del Donatore di Sangue 3, 10154 Turin, Italy.
authors.forename: Savino
authors.initials: S
authors.lastname: Sciascia
authors.affiliation: Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, King's College London, Westminster Bridge Road, London SE1 7EH, UK.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Cuadrado
authors.affiliation: Graham Hughes Lupus Research Laboratory, The Rayne Institute, Division of Women's Health, King's College London, Westminster Bridge Road, London SE1 7EH, UK.
authors.forename: Munther
authors.initials: M
authors.lastname: Khamashta
authors.affiliation: Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare and Università di Torino, Piazza del Donatore di Sangue 3, 10154 Turin, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Roccatello
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007238:Infarction / Q000209:etiology; D007668:Kidney / Q000098:blood supply; D007674:Kidney Diseases / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000473:pathology; D008181:Lupus Nephritis / Q000150:complications; D008875:Middle Aged; D011247:Pregnancy; D012082:Renal Veins; D013927:Thrombosis / Q000150:complications; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D017152:Antibodies, Antiphospholipid; D014859:Warfarin