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[Renal vascular lesion and microangiopathic hemolytic anemia in systemic lupus erythematosus]. / Lesión vascular renal y anemia hemolítica microangiopática en lupus eritematoso sistémico.
Gnocchi, C A; Yaryour, C; Kohan, A; De Rosa, G; Nadal, M.
Afiliación
  • Gnocchi CA; Quinta Cátedra de Medicina Interna, Universidad de Buenos Aires.
Medicina (B Aires) ; 57(2): 200-4, 1997.
Article en Es | MEDLINE | ID: mdl-9532830
A 22 year-old woman with a seven year history of (SLE) was readmitted because of oliguria, edema, dyspnea and arterial hypertension. She had a previous biopsy diagnosis of focal glomerulonephritis, (WHO III b), and had been treated with immunosuppressors and steroids. Laboratory data showed lupus activity, AHM with thrombocytopenia, nephrotic-range proteinuria and renal failure. A second renal biopsy was performed showing diffuse proliferative nephritis, (WHO IV), in association with noninflammatory necrotizing vasculopathy with luminal obliteration. She started with hemodialysis and was subsequently treated with methylprednisolone pulses, plasmapheresis, cyclophosphamide and oral steroids. During the inpatient period, she had generalized seizures, acute lung injury and pulmonary hemorrhage. These complications, the AHM and the thrombocytopenia receded totally. Renal function was never resumed. We emphasize that this association of diffuse proliferative nephritis with noninflammatory necrotizing vasculopathy is not infrequent and has a poor renal prognosis. The AHM with thrombocytopenia was interpreted as secondary to endothelial cell damage due to vasculopathy.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obstrucción de la Arteria Renal / Trombosis / Anemia Hemolítica / Riñón / Lupus Eritematoso Sistémico Tipo de estudio: Etiology_studies / Prognostic_studies Límite: Adult / Female / Humans Idioma: Es Revista: Medicina (B Aires) Año: 1997 Tipo del documento: Article Pais de publicación: Argentina
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obstrucción de la Arteria Renal / Trombosis / Anemia Hemolítica / Riñón / Lupus Eritematoso Sistémico Tipo de estudio: Etiology_studies / Prognostic_studies Límite: Adult / Female / Humans Idioma: Es Revista: Medicina (B Aires) Año: 1997 Tipo del documento: Article Pais de publicación: Argentina