Chakrabarti S, Ghosh A K, Bose J, De P K, Das K
Centre for Transfusion Medicine and Clinical Research, Calcutta.
J Indian Med Assoc. 1998 Sep;96(9):268-71.
Needle biopsies of kidney were done in 35 cases of systemic lupus erythematosus (SLE) with renal lesions. The lupus nephritis were classified according to WHO classification and were correlated with response to therapy and prognosis. Detailed clinical features, routine haematological, biochemical tests (e.g., serum urea, creatinine, total protein and albumin, cholesterol, etc), examination of urine (degree of proteinuria and cells) and occurrence of various auto-antibodies e.g., antinuclear antibody (ANA), anti double stranded DNA (anti DsDNA) by enzyme immunoassay (EIA) method, LE cells and rheumatoid factor (RF) were studied in all cases. Clinically hypertension was present in 19 (54.3%) cases and nephrotic range of proteinuria was detected in 20 (57.2%) cases. ANA was found in 31 (88.5%) cases, anti DsDNA 24 (68.5%) and LE cells were detected in 25 (71.5%) cases. RF was detected in 2 (5.7%) cases. Histologically the most frequent lesions were class IV occurring in 15 cases (42.8%) with initial complete remission achieved only 4 cases by immunosuppressive therapy. Active lesions were also most frequent in this class. Class III lesions were found in 8 (22.8%) cases with 6 cases had complete remission. The best prognosis was noted in class II cases with 4 out of 5 (14.3%) cases had complete remission. Class V lesions were found in 6 (17.2%) cases with complete remission achieved in 3 cases. Only one patient presented with class VI lesion. RF positive cases had milder renal lesions.
对35例有肾脏病变的系统性红斑狼疮（SLE）患者进行了肾脏穿刺活检。狼疮性肾炎根据世界卫生组织（WHO）分类进行分类，并与治疗反应和预后相关。研究了所有病例的详细临床特征、常规血液学和生化检查（如血清尿素、肌酐、总蛋白和白蛋白、胆固醇等）、尿液检查（蛋白尿程度和细胞）以及各种自身抗体的出现情况，如通过酶免疫测定（EIA）法检测抗核抗体（ANA）、抗双链DNA（抗DsDNA）、狼疮细胞（LE细胞）和类风湿因子（RF）。临床上，19例（54.3%）患者出现高血压，20例（57.2%）患者检测到肾病范围的蛋白尿。31例（88.5%）患者检测到ANA，24例（68.5%）检测到抗DsDNA，25例（71.5%）检测到LE细胞。2例（5.7%）患者检测到RF。组织学上，最常见的病变是IV类，15例（42.8%）出现，免疫抑制治疗仅4例最初完全缓解。此类中活动性病变也最常见。8例（22.8%）患者出现III类病变，6例完全缓解。II类病例预后最佳，5例中有4例（14.3%）完全缓解。6例（17.2%）患者出现V类病变，3例完全缓解。仅1例患者出现VI类病变。RF阳性病例的肾脏病变较轻。
