Lupus Podocytopathy:
A rare form of kidney involvement in systemic lupus erythematosus (SLE) characterized by nephrotic syndrome in the absence of traditional immune complex-mediated glomerular lesions.π§΅Threadπ
@12VRavindran @Renalpathsoc @ISNkidneycare @goKDIGO @Amansharmapgi #MedTwitter @DurgaPrasannaM1 @DrAkhilX @IhabFathiSulima @JasmineNephro @thisis_drgsp @arvindcanchi @Lupusreference @RheumNow @Janetbirdope
A rare form of kidney involvement in systemic lupus erythematosus (SLE) characterized by nephrotic syndrome in the absence of traditional immune complex-mediated glomerular lesions.π§΅Threadπ
@12VRavindran @Renalpathsoc @ISNkidneycare @goKDIGO @Amansharmapgi #MedTwitter @DurgaPrasannaM1 @DrAkhilX @IhabFathiSulima @JasmineNephro @thisis_drgsp @arvindcanchi @Lupusreference @RheumNow @Janetbirdope
- Light Microscopy in Lupus Podocytopathy: Normal glomeruli, minimal change disease (MCD)-like lesions, mesangial proliferation, or focal segmental glomerulosclerosis (FSGS) without endocapillary proliferation or thickening of the glomerular basement membrane.π§΅π
- Immunofluorescence: Absence of immune deposits in the glomerular capillary walls, although mesangial deposits may be present.
- Electron Microscopy: Diffuse foot process effacement (FPE) of podocytes, which is critical for the diagnosis.π§΅π
- Electron Microscopy: Diffuse foot process effacement (FPE) of podocytes, which is critical for the diagnosis.π§΅π
Lupus Podocytopathy represents about 1% of lupus nephritis (LN) biopsies.
It usually presents with nephrotic syndrome, often in young women and commonly within six months of SLE onset.
The clinical presentation is similar to idiopathic nephrotic syndrome, with sudden onset and massive proteinuria. π§΅π
It usually presents with nephrotic syndrome, often in young women and commonly within six months of SLE onset.
The clinical presentation is similar to idiopathic nephrotic syndrome, with sudden onset and massive proteinuria. π§΅π
- Histological Classification: LP isn't officially included in the International Society of Nephrology/Renal Pathology Society (ISN/RPS) @isn @Renalpathsoc @isn_india classification of LN but is recognized as a distinct entity.
It's noted for its association with active lupus manifestations and serologic activity.
It's noted for its association with active lupus manifestations and serologic activity.
- Treatment Response: Patients with LP, especially those with MCD-like features, tend to respond well to steroid therapy, often showing rapid remission.
However, those with FSGS lesions may have a higher rate of relapse and less consistent response to treatment.
The addition of immunosuppressive agents alongside steroids can decrease relapse rates.π§΅π
However, those with FSGS lesions may have a higher rate of relapse and less consistent response to treatment.
The addition of immunosuppressive agents alongside steroids can decrease relapse rates.π§΅π
- Prognosis: While the prognosis is generally optimistic, the FSGS subtype of LP has a more dismal outlook with higher rates of acute kidney injury (AKI), hypertension, and severe tubulointerstitial involvement.
Relapse rates are high, potentially necessitating long-term or maintenance therapy. #nephrology #NephroTwitter #MedTwitter #RheumatTwitter
Relapse rates are high, potentially necessitating long-term or maintenance therapy. #nephrology #NephroTwitter #MedTwitter #RheumatTwitter
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