Clinicopathological presentation of treatment naive crescentic v/s non-crescentic lupus nephritis patients

AUTHORS : Doley PK, Alam Shahzad, Sharma Manjuri, Mahanta PJ, Awasthi Shahtakshi, Jain Priyanka
DOI No. :

ABSTRACT : Introduction: Renal biopsies play an important role in the diagnosis, management and prognosis of patients with lupus nephritis (LN).This paucity of knowledge in this particular area prompted us to undertake this retrospective analysis of clinicopathological presentation of biopsy-proven LN. Materials and methods: Biopsy proven (n=120) treatment naive LN class IV patients from March 2007 to August 2018 were included. Out of these, 85 were class IV non-crescentic and 35 were class IV crescentic lupus nephritis patients. Clinical and histopathological data were studied retrospectively. Results: Patients with crescentic LN presented with significantly more severe disease (anemia, renal failure, higher serum creatinine level and hypertension and hematuria) as compared to the non-crescentic group (p <0.05). Mean scores of activity index and chronicity index increscentic LN patients were significantly higher (p < 0.001 and 0.014 respectively), and not crescent but near about all parameters (except glomerular sclerosis, p = 0.61 and subendothelial immune deposition, p = 0.52) of these scores were significantly higher in the crescentic group. The average intensity of IgG, IgA, IgM, and C3 was lower and average intensity of C1q was higher in the crescentic group. But only the difference in IgA reached statistical significance. Conclusion: In our study, crescentic LN patients had lower hemoglobin levels, with more hematuria and hypertensive patients and also had higher Activity Index and Chronicity Index compared to non-crescentic LN. Not only crescent but, near about all parameters of these scores were significantly higher in crescentic group. The average intensity of IgA was significantly higher in non- crescentic group in IF study.

Keywords: Activity index; histopathology; chronicity index; glomerulonephritis.

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