title: Vasculitis and vasculopathy in Lupus Nephritis: Clinical variability, outcome, and new insight into treatment.
abstract: More than 50% of patients with systemic lupus erythematosus (SLE) have renal involvement at presentation or during their illness. Lupus nephritis (LN) encompasses several patterns of renal disease, including glomerular, tubulointerstitial, and vascular pathologies. The presence and significance of renal vascular lesions (VLs) are often overlooked. VLs in LN are not rare with an incidence of 10%-40% on renal biopsies from various studies and their presence is often labeled as poor prognostic markers. The current treatment protocol for LN is mainly based on the glomerular pathology, and no guidelines/consensus exists for treatment of LN with VLs. We describe the clinical presentation, course, response to therapy, and outcomes in five patients with SLE with histological evidence of renal VLs.
authors.affiliation: Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: A
authors.initials: A
authors.lastname: Kaul
authors.affiliation: Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: V
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: D
authors.initials: D
authors.lastname: Bhaduaria
authors.affiliation: Department of Immunology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Agrawal
authors.affiliation: Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Narayan
authors.initials: N
authors.lastname: Prasad
authors.affiliation: Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Sharma
mesh_terms: D000328:Adult; D001706:Biopsy; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D008181:Lupus Nephritis / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D008875:Middle Aged; D010956:Plasmapheresis; D012074:Remission Induction; D006435:Renal Dialysis; D016896:Treatment Outcome; D014657:Vasculitis / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents