Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing, PR China.
Kidney Int. 2009 Aug;76(3):307-17. doi: 10.1038/ki.2009.136. Epub 2009 Apr 29.
There are few clinicopathologic and outcome data on patients with crescentic lupus nephritis, therefore, we determined factors of the disease by retrospectively reviewing the records of 327 patients diagnosed with lupus nephritis. Of these, 152 cases were regrouped as class IV-G, including 33 patients with crescentic glomerulonephritis. Significantly, all patients with crescentic glomerulonephritis had acute kidney injury as compared with only about a quarter of the patients without the disease. On pathological evaluation, activity scores, chronicity indexes, relapse rates, and the frequency of positive serum anti-neutrophil cytoplasmic antibody (ANCA) were each significantly higher, whereas complete remission rates and renal outcomes, over a mean follow-up of 4 years, were significantly poorer in patients with crescentic glomerulonephritis. Our study shows that crescentic glomerulonephritis was not rare in patients with lupus nephritis and that their long-term outcome was poor. The precise role of ANCA in the pathologic course of crescentic lupus nephritis remains to be determined.
关于新月体型狼疮肾炎患者的临床病理和预后数据较少，因此，我们通过回顾性分析 327 例狼疮肾炎患者的记录来确定疾病的相关因素。其中，152 例被重新分为 IV-G 类，包括 33 例新月体性肾小球肾炎患者。值得注意的是，与没有该疾病的患者相比，所有新月体性肾小球肾炎患者均有急性肾损伤。在病理评估中，活动评分、慢性指数、复发率和抗中性粒细胞胞浆抗体（ANCA）阳性血清的频率均显著升高，而新月体性肾小球肾炎患者的完全缓解率和肾脏预后在平均 4 年的随访中显著较差。我们的研究表明，新月体性肾小球肾炎在狼疮肾炎患者中并不少见，其长期预后较差。ANCA 在新月体型狼疮肾炎的病理过程中的确切作用仍有待确定。
