Amigo M C, Garcia-Torres R, Robles M, Bochicchio T, Reyes P A
Department of Rheumatology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
J Rheumatol. 1992 Aug;19(8):1181-5.
Our objective was to define the renal involvement in primary antiphospholipid syndrome (APS). We studied 20 patients with primary APS. Fourteen were women, mean age 34.4 years. None met ARA criteria for systemic lupus erythematosus. All patients underwent complete renal function studies. The presence of hypertension was also investigated. Renal disease was found in 5 patients, and was characterized by proteinuria, hypertension and renal failure. Kidney biopsy was performed in these 5 patients, showing thromboses of the microvasculature, mesangiolysis, mesangial interposition, electron lucent subendothelial material and ischemic obsolescence of glomeruli. Arterioles showed luminal narrowing due to medial hypertrophy, mucoid thickening of the intima, thrombosis and fibrosis. We found renal disease in 25% of our patients with primary APS. Biopsy findings were consistent with a thrombotic microangiopathy involving both arterioles and glomerular capillaries.
我们的目的是明确原发性抗磷脂综合征（APS）中的肾脏受累情况。我们研究了20例原发性APS患者。其中14例为女性，平均年龄34.4岁。无一例符合美国风湿病学会（ARA）系统性红斑狼疮的标准。所有患者均接受了完整的肾功能检查。同时也对高血压情况进行了调查。5例患者发现患有肾脏疾病，其特征为蛋白尿、高血压和肾衰竭。对这5例患者进行了肾活检，结果显示微血管血栓形成、系膜溶解、系膜插入、电子透明的内皮下物质以及肾小球缺血性荒废。小动脉显示由于中层肥厚、内膜黏液样增厚、血栓形成和纤维化导致管腔狭窄。我们发现25%的原发性APS患者患有肾脏疾病。活检结果与累及小动脉和肾小球毛细血管的血栓性微血管病相符。
