Histopathological study of renal biopsies and its correlation with clinical features in primary Sjgren's syndrome
- VernacularTitle:原发性干燥综合征肾脏损害病理及其临床相关性分析
- Author:
Min WU
;
Fie-Ping PAN
;
- Publication Type:Journal Article
- Keywords:
Sjgren's syndrome;
Kidney;
Histopathology
- From:
Chinese Journal of Rheumatology
2001;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the histopathological features of renal lesions in patients with prima- ry Sjgren's syndrome(pSS)and the correlation between the findings with clinical manifestations.Methods Kidney and labial salivary gland biopsies from 16 patients with pSS were studied by a semiquantitative assess- ment approach.Results Among these pSS patients,light microscopy showed acute or chronic interstitial nephritis(IN,8/16),diffuse mesangial proliferative glomerulonephritis(MePGN,3/16),mild mesangial prolifer- ative glomerulonephritis(3/16),focal segmental glomerulosclerosis(FSGS,2/16),membranoproliferative glomeru- lonephritis(MPGN,1/16)and membranous nephropathy(MN,2/16).There were 11/16(68.8%)cases had renal tubular acidosis(RTA),8 cases of them presented with IN.In two chronic renal failure cases,one showed MN and another showed IN accompanied with FSGS.Immunofluorescent examination revealed deposition of IgG, IgA,IgM,C3,Clq on the glomerular basement membrane or tubular basement membrane,mesangium focally.It was noted that the interstitial inflammation was focal in 85% of the patients and was always combined with dif- fusely distributed cellular infiltrates.The percentage of obsolescent glomeruli was found correlated with the level of vessel wall thickening(r=0.77,P=0.001)but not with the grade of tubular atrophy and interstitial fi- brosis.Creatinine clearance was correlated with the adjusted chronic tubulointerstitial nephritis(CTIN)score (r=-0.52,P=0.04)and the percentage of obsolescent glomeruli(r=-0.53,P=0.04).No association could be found between the labial salivary gland and the renal focus scores(r=0.28,P=0.30).Conclusions The renal tubular acidosis and IN are the most common findings in pSS patients with renal involvement.Glomerular dam- age is not uncommon,althought mild and is not merely secondary.Timely renal biopsy can help to estimate prognosis and guide therapy.
